The state of central and peripheral hemodynamics in patients with out-of-hospital pneumonia associated with subclinical hypothyroidism

Abstract

Objective: to investigate the state of сеntral and peripheral hemodynamics in patients with out-of–hospital pneumonia (OHP) combined with subclinical hypothyroidism (SH). Materials and methods: the study was conducted in 132 patients with OHP of clinical groups II-III, including 64 with OHP combined with SН — the main group, and 68 with OHP without SН (comparison group). The average age of the patients was 37.4±3.3 years, including 74 women among the studied, 58 men. The state of microcirculation in patients was studied by biomicroscopy of the bulbar conjunctiva using a slit lamp with the calculation of conjunctival indices, intravascular aggregation of shaped blood elements was observed in the presence of a sludge phenomenon according to N. Knisely (1965), and central cardiohemodynamics parameters were determined. Results: in patients with OHP, along with small clinical signs of hypertension, laboratory data were revealed: TSH — (6,4±0,6) мIU/ml, free T4 — (13,2±1,1) pmol/L, the level of ATP — 53,7±2,3 IU/ml — microcirculatory disorders with changes in the microvascular wall, sludge in them, perivascular changes, as well as dysfunction of the right and left ventricles of the heart. Conclusions: the combination of OHP and SH in patients is accompanied by significant microvascular shifts, which are associated with disorders of central cardiohemodynamics in the form of dysfunction of the right and left ventricles of the heart. The found correlations between the parameters of cardiohemodynamics and microcirculation in patients with OHP combined with SH and TSH levels confirm the negative effect of subclinical hypothyroidism on the state of central and peripheral hemodynamics in patients.