Thyroid-stimulating hormone and mortality in pulmonary arterial hypertension.
Thyroid-stimulating hormone and mortality in pulmonary arterial hypertension.
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促甲状腺激素与肺动脉高压死亡率
DOI：
10.1136/bmjresp-2022-001348
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发表时间：
2022-07
影响因子：
4.1
通讯作者：
中科院分区：
文献类型：
--
作者：
肺动脉高压（PAH）仍然是一种严重的危及生命的疾病。甲状腺功能障碍在PAH患者中的研究相对不足，但已知会影响其他疾病的心脏功能和血管张力。本观察性研究的目的是评价PAH患者促甲状腺激素（TSH）、死亡和非死亡结局之间的相关性。西雅图右心耳转化科学（Servetus）研究是一项观察性队列，招募了2014年至2016年期间患有PAH的受试者，然后对其进行了3年随访。无论临床上是否怀疑患有甲状腺疾病，均对队列中的所有参与者进行TSH测量。用直线回归法分析TSH与右室基底径、三尖瓣环平面收缩期位移及6分钟步行距离的关系。Logistic回归分析与纽约心脏协会心功能分级的关系，考克斯比例风险分析与死亡率的关系。分期模型包括未调整模型和解释年龄、出生性别和肺动脉高压病因的模型，有或没有进一步调整N-末端脑钠肽激素原。在112例PAH受试者中，TSH与死亡率密切相关，不考虑调整。在PAH队列中，TSH与其他严重程度标志物之间没有明确一致的相关性。本报告强化了TSH与PAH患者生存率相关的重要观察结果，并且有必要进一步研究甲状腺功能障碍作为PAH死亡率的潜在可补救因素。
Pulmonary arterial hypertension (PAH) remains a serious and life-threatening illness. Thyroid dysfunction is relatively understudied in individuals with PAH but is known to affect cardiac function and vascular tone in other diseases. The aim of this observational study was to evaluate the association between thyroid-stimulating hormone (TSH), mortal and non-mortal outcomes in individuals with PAH. The Seattle Right Ventricle Translational Science (Servetus) Study is an observational cohort that enrolled participants with PAH between 2014 and 2016 and then followed them for 3 years. TSH was measured irrespective of a clinical suspicion of thyroid disease for all participants in the cohort. Linear regression was used to estimate the relationships between TSH and right ventricular basal diameter, tricuspid annular plane systolic excursion and 6-minute walk distance. Logistic regression was used to estimate the relationship with New York Heart Association Functional Class, and Cox proportional hazards were used to estimate the relationship with mortality. Staged models included unadjusted models and models accounting for age, sex at birth and aetiology of pulmonary hypertension with or without further adjustment for N-terminal-pro hormone brain natriuretic peptide. Among 112 participants with PAH, TSH was strongly associated with mortality irrespective of adjustment. There was no clear consistent association between TSH and other markers of severity in a cohort with PAH. This report reinforces the important observation that TSH is associated with survival in patients with PAH, and future study of thyroid dysfunction as a potential remediable contributor to mortality in PAH is warranted.
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影响因子：
5.9
作者：
Grais, Ira Martin;Sowers, James R.
通讯作者：
Sowers, James R.
影响因子：
3.1
作者：
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通讯作者：
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影响因子：
9.6
作者：
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通讯作者：
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影响因子：
8.9
作者：
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通讯作者：
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DOI：
10.1164/rccm.201209-1640oc
发表时间：
2013-08-01
影响因子：
24.7
作者：
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通讯作者：
Dweik, Raed A.