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Thyroid Hormones and Cardiac Dilatation and Dysfunction In Iraqi Patients with Idiopathic Dilated Cardiomyopathy Biochemical and Echocardiographic Study

Author: Basil O.M. Saleh
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2007 Volume: 6 Issue: 1 Pages: 41-44
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Serum thyroid hormone level can provide a quantitative index for evaluating the severity of chronic heart failure.OBJECTIVES:To assess the contributions of thyroid hormones [tri-iodothyronine] (T3) and thyroxine (T4)] to the left ventricular (LV) dilatation and myocardial dysfunction in patients with idiopathic dilated cardiomyopathy (IDC).METHODS:Forty patients with idiopathic dilated cardiomyopathy (IDC) aged 46.20 + 1.90 years, as (mean ± SEM) (11 females and 29 males) were studied. Serum total T3, total T4 and thyroid-stimulating hormone (TSH) were measured in these patients. Echocardiographic parameters including LV systolic diameter, septal thickness systolic diameter, LV diastolic diameter, septal thickness diastolic diameter and LV ejection fraction (LVEF) were also be assessed in all patients.RESULTS:This study showed that the serum T4 values were significantly directly correlated with the values of EF % (r = 0.34; p < 0.035) along with significant inverse relationship between serum levels of T3 and the diameter of LV systole (r = - 0.34; p< 0.032).CONCLUSION:This study revealed an important significant correlation between serum thyroid hormones levels and echocardiographic parameter values that may point to the role of these biochemical factors in the contribution to the LV dilatation and cardiac dysfunction (heart failure) .


Article
Selenium Status and Echocardiographic Parameters in Iraqi Patients with Idiopathic Dilated Cardiomyopathy

Author: Basil O.M. Saleh
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2007 Volume: 6 Issue: 1 Pages: 45-48
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:It has been speculated that trace elements may play a role in the pathogenesis of dilated cardiomyopathy (DCM) .In the present study, we aimed to assess serum concentrations of selenium (Se) in Iraqi patients with idiopathic dilated cardiomyopathy (IDC) and to evaluate the correlation between serum Se concentrations and echocardiographic parameters.METHODS:This study included 28 patients with IDC and 22 healthy controls .Serum level of selenium was measured by atomic absorption spectrophotometry method .Echocardiographic parameters including left ventricular end diastolic diameter (LVEDD), LV end- systolic diameter (LVESD) ,and LV ejection fraction (LVEF) were measured in all patients with IDC in order to evaluate its correlation with serum Se concentrations.RESULTS:Serum concentration of Se in IDC patients was significantly lower than in healthy controls (p<0.001).Relationships of the serum Se levels with echocardiographic and clinical parameters were not statistically significant.CONCLUSION:The present study confirmed that IDC is associated with decreased serum Se concentrations. This change in Se may play an important role in the pathogenesis of myocardial damage in IDC


Article
High Density Lipoprotein Cholesterol: A New Protective Function of Cardiac Structure and Function of Idiopathic Dilated Cardiomyopathy

Author: Basil O.M. Saleh
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2007 Volume: 6 Issue: 1 Pages: 49-53
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:There is a suggestion that abnormal coronary physiology may be exist early in the course of idiopathic dilated cardiomyopathy (IDC), and is likely to play an important role in the pathogenesis and progression of the myopathic state in such patients. With regard to lipid profile, high-density lipoprotein cholesterol (HDL-C) particle enhances NO production and improves endothelium relaxation.METHODS:This study included 50 patients aged 19-72 years (13 females and 37 males) with IDC and 23 healthy controls aged 29 to 60 years (9 females and 14 males). Lipid profile, should be at least 12 hours fasting, including serum total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) were evaluated in these two groups. Measurements of some of echocardiographic parameters including left ventricular (LV) systolic and diastolic diameters, and LV ejection fraction (LVEF) in IDC patients, and correlate its values with each one of the above lipid parameters in order to define the more predictor lipid parameter in evaluating the structure and function of the heart.RESULTS:The mean values of serum total cholesterol and LDL-C were insignificantly higher in patients with IDC patients than in controls. The mean of serum HDL-C was significantly low in IDC group against controls (P< 0.001). The mean (± SEM) serum triglyceride TG levels in patients with IDC was significantly increased when they were compared to that of normal controls (P< 0.05). An important inverse relation was observed between serum levels of HDL-cholesterol and LV diastolic diameter values (r= - 0.29, P< 0.039) as well as between HDL-cholesterol levels and LV systolic diameter values (r= - 0.33, P< 0.02). A borderline significant positive correlation between serum concentrations of HDL-cholesterol and the values of EF % was also shown in the IDC patients(r= 0.28, P< 0.05).CONCLUSION:The result of this study may point to the role of HDL-C in contribution to the LVdilatation and myocardial dysfunction (heart failure) in IDC.


Article
Homocysteine and Thyroid Hormones in Patients with Familial Dilated Cardiomyopathy

Author: Basil O.M. Saleh
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2007 Volume: 6 Issue: 2 Pages: 88-91
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Familial linkage of primary dilated cardiomyopathy (DCM) occurs more commonly than often is appreciated. In 10-20 percent of patients, a first degree relative also shows evidence of primary DCM suggesting that familial transmission is relatively frequent.METHODS:this study included 7 patients aged 40-70 years (2 females and 5 males) with familial dilated cardiomyopathy (FDCM) and 17 healthy subjects aged 29-60 years (6 females and 11 males). Plasma fasting total homocysteine tHCY, serum folic acid (FA), vitamin B6, total triiodothyronine (T3), and total thyroxine (T4) were measured in these two groups.RESULTS:The mean value of plasma tHCY was significantly higher in patients with FDCM than in control (P<0.001). The mean (±SD) values of serum folic acid and vitamin B6 were significantly decreased in FDCM patients when compared with those of control group (P<0.05, P<0.01, respectively).A significant inverse relationship between plasma tHCY concentration and the values of serum FA was shown in the FDCM patients (r=-0.78, P<0.05). The mean values of serum T3 and T4 were insignificantly decreased in patients with FDCM than in controls.CONCLUSION:The level of plasma tHCY is significantly higher in FDCM patients than in healthy control. This severe hyperhomocyteinemia of FDCM patients may be related to evolution and development of myopathic state in such patients.

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