Clinical and immunological aspects of cardiovascular disorders in Graves'' disease and chronic heart failure
The aim of the study was to estimate a level of thyrotropin-receptor antibodies (TRAb), some cytokines (TNF-?, IL-8, IL-10) in Graves' disease patients with chronic heart failure (CHF) and to reveal prognostic factors of CHF.89 patients with Graves' disease were investigated, chronic heart failure was diagnosed in 46 (51.7%) cases, from them 1 stage – in 27 (58.7%) patients, 2А – in 17 (37.0%) and 2b – in 2 (4.3%) patients. However, the tachycardia, a dyspnea and other symptoms at СHF 1 stages could be eхplained by CHF as well as by Graves' disease, therefore the firs group was composed from 19 (21.3%) patients with Graves' disease and CHF 2А and 2b. Second group – 43 patients with Graves' disease without any signs of CHF. The control group (3 group) was conducted from 30 healthy persons. It was revealed, that the most important risk factors of CHF in patients with Graves' disease are: presence of constant form atrial fibrillation and arterial hypertension, age older than 40 years, male sex, duration of Graves' disease 10 years and more, 6 and more episodes of thyrotoxicosis. There wasn't any correlation between the level of TRAb and the risk of CHF in Graves' disease. We found an imbalance of cytokines system in comparison with control group, prevalence of “proinflammatory activation”, however statistically significant interrelations between IL-8, IL-10 and TNF-? levels in different groups of patients with Graves disease was not found.