Papers of the Week

The low T3 syndrome, the most common type of Sick Euthyroid syndrome, once believed to be a beneficial adaptive mechanism under conditions of stress, has emerged as a strong prognostic determinant in chronic systolic heart failure. Sick Euthyroid Syndrome is frequently observed in Chronic Heart Failure, Acute Myocardial Infarction. Acute myocardial infarction (AMI) may be associated with a number of endocrine alterations, including those of the SES which reflect the acute hormone response to stress and trauma. It is known from several studies that several cytokines can be found elevated in patients with cardiac ischemia or AMI. From in vitro studies it is of particular interest that ischemic myocytes produce cytokines such as interleukin-6 (IL-6) and its synthesis is accelerated by reperfusion. Interleukin-6 seemed to be an important cytokine produced by the injured myocytes in patients with AMI, and strong negative correlation between serum IL-6 concentration and left ventricular ejection fraction (LVEF) has been demonstrated. Similar observations have been made by studying tumor necrosis factor-a (TNF-a), IL-1a and soluble IL-2 receptor (sIL-2-R) which were found to be significantly elevated in AMI, with the highest levels noted in the most severe and complicated cases of myocardial infarction.