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Eur J Cardiothorac Surg 2004;26:720-725
© 2004 Elsevier Science NL

Oral thyroid hormone pretreatment in left ventricular dysfunction

Mustafa Sirlak^*, Levent Yazicioglu, Mustafa Bahadr Inan, Sadik Eryilmaz, Refik Tasoz, Atilla Aral, Umit Ozyurda

Cardiovascular Surgery, Ankara University, School of Medicine, Ankara, Turkey

Received 31 March 2004; received in revised form 16 June 2004; accepted 1 July 2004.

^* Corresponding author. Yesilyurt Sok. 49/1, A.Ayranc, Ankara, Turkey. Tel.: +90-532-235-52-42; fax: +90-312-362-48-25. (E-mail: drsirlak{at}hotmail.com).

Objective: The aim of the present study was to determine whether pretreatment with oral thyroid hormone had beneficial effects in cardiac function and morbidity and mortality after cardiac operations. Methods: Eighty patients undergoing coronary artery bypass grafting with a preoperative left ventricular ejection fraction (LVEF) less than 30% scheduled for elective coronary bypass grafting agreed to participate in this prospective, randomized trial. The triiodothyronine (T₃) (Group I) and control groups (Group II) were equally divided. Patients randomized to the T₃ group received T₃ 125µg/day orally for 7 days preoperatively and from the first postoperative day till the discharge. Outcome variables included perioperative hemodynamic data, inotropic requirements, morbidity and mortality. Hemodynamic data were collected before induction of anesthesia and following every 4h. The thyroid profile was determined upon admission, after the induction of anesthesia, 5min after the start of cardiopulmonary bypass (CPB) and after hourly intervals and after 24th hour, at 24h intervals till the 120th hour. Results: There were 6 deaths, three in each group. Patients in the T₃ group demonstrated a higher cardiac index than patients in the placebo group in the entire post-CPB periods (P<0.01). Mean inotropic requirements remained lower in the T₃ group than in the placebo group (P<0.001). Conclusions: Although our study stresses the benefits of oral T₃ administration on the hemodynamic and prognostic parameters in patients with impaired left ventricular function and undergoing CABG weakly, it may warrant further much larger scaled studies that can reach statistical significance.

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