Abstract:

INTRODUCTION: Thyroid hormones (TH) play a significant role in cardiovascular (CV) homeostasis. When the effect of TH on the CV system has been examined, especially in recent years, "euthyroid sick syndrome (ESS)" has attracted attention. In this study, we aimed to investigate the correlation between ESS, which is frequently observed in hospitalized patients with have systemic disease, and the brain natriuretic peptide (BNP) level. METHODS: In this cross-sectional study, 78 ESS patients who were hospitalized for various systemic diseases and a control group of 67 euthyroid patients were included. Patients who have heart failure (HF) with clinical and/or laboratory findings, renal failure, chronic liver disease, renal parenchymal disease, known hyperthyroidism or hypothyroidism, taking a thyroid hormone, using steroids, using antithyroid drugs, known to affect the BNP level Patients using medication were excluded from the study. The serum brain natriuretic peptide (BNP) levels, biochemical examinations, acute phase reactants, and echocardiography findings were analyzed. RESULTS: Serum BNP was significantly higher in ESS patients compared to the control group. Serum free thyroxine (fT4) level was positively correlated, and serum free triiodothyronine (fT3) and thyroid stimulating hormone (TSH) levels were negatively correlated with BNP. Furthermore, it was determined that serum BNP level was positively correlated with positive acute-phase reactants (high-sensitivity C-reactive protein, ferritin) and negatively correlated with albumin, which is a negative acute-phase reactant. DISCUSSION AND CONCLUSION: ESS is associated with an increase in serum BNP. In critically ill patients without CV disease, a low level of fT3 may contribute to the development of cardiac dysfunction. We consider that the patient's age, admission diagnosis, acute-phase reactants, and inflammatory cytokines should be considered in addition to thyroid hormones while evaluating BNP levels in ESS.

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