Frequency and Relevance of Thyroid Dysfunction in Patients with Chronic Heart Failure: A Cross Sectional Study at Yaoundé Central Hospital, Cameroon

Author(s): Kemnang Yemele Honoré, Vicky J Ama Moor, Liliane Mfeukeu Kuate, Etoa Martine, Tcheutchoua Nzokou Daryl, Batakeh B Agoons, Esther Mbono Samba, Falmata Amazia, Nangue Tiogoung Gaelle, Ossongo

Background: Abnormalities of thyroid function have been reported in patients with heart failure (HF). We aimed to evaluate the frequency and clinical relevance of dysthyroidism in Cameroonians with HF.

Methods: This was a cross-sectional study from January to May 2020. Including consenting adults followed up at the Yaoundé Central hospital for HF. We assessed serum level of TSH, free T₃ and free T₄ using ELISA method. We sought for associations between thyroid hormones levels and HF-related variables using Pearson and Spearman correlations tests. The threshold of significance was set at 0.05.

Results: 63 participants were included (33males) with a mean age of 62 ±14 years. Among them, 33 (52%) were hypertensive, 16 (25.4%) had atrial fibrillation, and half (52%) had stage II HF according to the New-York Heart Association. Dysthyroidism was found in 25 subjects (39.6%), with 17 (26.9%) and 6 (9.5%) cases of low-T₃ syndrome, and subclinical hyperthyroidism respectively. TSH levels were weakly but significantly correlated with the stage of HF (r=0.31, p=0.01) and slightly correlated with left ventricular ejection fraction (LVEF) (r=-0.31, p=0.01). Free T₃ levels were weakly but significantly correlated with the number of hospitalizations over the last 12 months (r=-0.36, p<0.01), and the LVEF (r=0.28, p=0.02).

Conclusion: Dysthyroidism affects nearly two out of five patients suffering from heart failure in our sample. It could be associated with a more severe clinical presentation. More studies need to be done to assess the long-term prognosis in sub-Saharan African populations with HF and dysthyroidism.