LIVER FUNCTIONAL STATUS IN PATIENTS WITH ATRIAL FIBRILATION AND AMIODORONE-INDUCTED THYROID DYSFUNCTION
Keywords:atrial fibrillation, amiodarone, amiodarone-induced thyroid dysfunction, liver function.
The purpose of the work was to establish the frequency and conditions of occurrence of functional changes
of the liver depending on thyroid dysfunction against the background of long-term use of amiodarone.
The study included 80 patients with cardiosclerosis with atrial fibrillation (AF). The patients were assigned
to: group I (n = 60) — received amiodarone at a maintenance dose for one year (on background of basic therapy);
сomparison group (CG) — patients (n = 20) who received on the background of basic therapy digoxin and bisoprolol.
Biochemical tests were conducted: free triiodothyronine (fT3), thyroid-stimulating hormone (TSH), free
thyroxine (fT4), antibodies to thyroperoxidase (anti-TPO Ab), activity of ALT, AST, alkaline phosphatase (AF),
total bilirubin, thymol test (TT), arginase, gama glutamil transpeptidase (GGT). Thyroid dysfunction during
administration of amiodarone was detected in 20 (33.3 %) patients of group I — amiodarone-induced hypothyroidism
(AmIH) in 12 (20.0 %) patients, amiodarone-induced thyrotoxicosis (AmIT) in 8 (13.3 %) patients.
Cholestasis was detected in 83.3 % of patients with AmIH and 75.0 % with AmIT, which was accompanied by an
increase of the AF activity and GGT, which were more pronounced in case of AmIH. Half of patients with AmIT
presented with increased total bilirubin, ALT and AST activity opposed to sixth of AmIG patients. Increased
arginase activity, tendency to increase of TT was determined in almost half of patients with AmIG and AmIT.
Amiodarone-induced thyroid dysfunction is characterized by the development of drug-induced hepatocellular
toxicity, which is manifested by a cholestatic, cytolytic syndrome and accompanied by an energetic changes
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