Relative Effects of Enhanced External Counter Pulsation Therapy on Thyroid Hormones in Heart Failure Treatment

Thyroid hormone and its metabolism have been shown to be abnormal in patients with non-thyroidal illnesses such as those with advanced heart failure. Free T3/Reverse T3 ratio is believed to be associated with a reduced ejection fraction and poor short-term outcomes in patients with advanced heart failure. We sought to evaluate the effects of Enhanced External Counter Pulsation Therapy (EECP) on the thyroid hormone profile of heart failure patients. Our study group consisted of 30 patients referred for the management of heart failure. Each patient underwent treatment by EECP, and free Triiodothyronine (T3) level alterations were monitored before the commencement of treatment and once again after the completion of standard EECP treatment. Thirty patients with advanced heart failure symptoms at a median age of 65 (46-77) years were enrolled. After EECP therapy, the ejection fraction was improved significantly. The median ejection fraction after EECP treatment was 46.5% (p value <0.001). T3 levels increased to 4.01 +/-1.46 (ng/dl); this, however, was not a significant finding (p value =0.44). Treatment of heart failure by EECP may have some effects on thyroid hormone milieu and metabolism insofar as T3 levels rose after EECP in our study, although this effect was not statistically significant. More thorough investigations are needed before any conclusion could be made on this matter. (Iranian Heart Journal 2012; 13(2):35-39).