ArticleFrontiers in endocrinology2025
Association between peripheral thyroid sensitivity defined by the FT3/FT4 ratio and composite adverse outcome among inpatients with heart failure.
Article in Frontiers in endocrinology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Thyroid-metabolic interactions in pediatric epilepsy: insights from central sensitivity indices and peripheral hormone markers.European journal of pediatrics · 2026Article
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5 authors.
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Abstract
Objective: The free triiodothyronine to free thyroxine (FT3/FT4) ratio is an indicator of peripheral thyroid hormone sensitivity. However, its prognostic value in heart failure (HF) remains unclear. Methods: This single center prospective cohort study included a total of 402 HF patients. The primary composite outcome was established as either mortality from any cause or HF-related hospitalization within one year. Multivariate Cox regression and Kaplan-Meier analysis assessed associations between the FT3/FT4 ratio and composite endpoint risks, with restricted cubic splines (RCS) exploring potential non-linear relationships. Results: Among 402 heart failure patients, 188 (46.8%) experienced the primary composite endpoint. The highest FT3/FT4 tertile (T3) had 38% lower risk than the lowest tertile (T1) (adjusted HR 0.62, 95% CI 0.41-0.94). In the subgroup of patients with subclinical hypothyroidism (SCH), T3 individuals showed an 84% lower risk compared to T1 (adjusted HR 0.16, 95% CI 0.03-0.81). Both the overall cohort and SCH subgroup exhibited an inverse association between FT3/FT4 ratios and adverse outcomes, whereas euthyroid patients demonstrated a U-shaped relationship with composite endpoint hazards (P for nonlinear = 0.004). Conclusions: Our findings suggest that maintaining or restoring higher FT3/FT4 levels may improve clinical outcomes in HF patients. Regular monitoring of this ratio, coupled with tailored interventions based on thyroid functional status, could enhance risk stratification and therapeutic decision-making.
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