ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardiovascular Metabolism
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1546309
Prognostic Significance of FT3 Levels in Hypertrophic Cardiomyopathy Patients with HFpEF
Provisionally accepted
Chun-jin Lai1*
Zhen-Yu Yang2Zhi-Yuan Zhang3Wei-Jie Zhang4
Da Liu5Fu-Shi Piao6Xiangyu Yan7Fang- Tao Shi2Min Yang8Jing Chen8Sheng-Song Zhu8Hong-Hou He5Pei-Hong Wu5Cheng Qian9Min Lin10Jun-Qing Feng2- 1Dongguan Taixin Hospital, Dongguan, China
- 2The People's Hospital of Anyang City, Anyang, China
- 3Zhengzhou University, Zhengzhou, Henan Province, China
- 4Henan Provincial People's Hospital, Zhengzhou, Henan Province, China
- 5Hebei Medical University, Shijiazhuang, Hebei Province, China
- 6Shenzhen Hospital, Peking University, Shenzhen, Beijing Municipality, China
- 7Tianjin University, Tianjin, Tianjin, China
- 8Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Beijing Municipality, China
- 9Peking University, Beijing, Beijing Municipality, China
- 10The University of Hong Kong, Pokfulam, Hong Kong, SAR China
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Objective: This study sought to identify key prognostic factors in patients with hypertrophic cardiomyopathy (HCM) and heart failure with preserved ejection fraction (HFpEF), emphasizing the prognostic role of free triiodothyronine (FT3) levels.Methods: This retrospective cohort study enrolled 992 HCM-HFpEF patients from two Chinese medical centers between 2009 and 2019, excluding those with thyroid-affecting medications or disorders. Data on demographic and clinical variables, including FT3, were analyzed using univariate and multivariate Cox regression, Kaplan-Meier (KM) survival analysis, and restricted cubic spline (RCS) analysis to explore prognostic factors and FT3's nonlinear predictive value.Results: Age, atrial fibrillation, and NT-proBNP levels significantly influenced prognosis, while FT3 emerged as an independent predictor of all-cause mortality and cardiac transplantation (P < 0.001). Patients with lower FT3 exhibited poorer long-term outcomes, with RCS identifying a critical threshold of 2.885 pg/mL (P-non-linear < 0.05).Conclusions: FT3 is a robust prognostic marker in HCM-HFpEF patients, supporting its integration into risk stratification. Clinicians should monitor FT3 levels, though intervention efficacy requires further prospective validation.
Keywords: HCM-HFpEF, prognosis, FT3, Thyroid function, All-cause mortality, Cardiac transplantation, NonLinear Analysis
Received: 16 Dec 2024; Accepted: 17 Apr 2025.
Copyright: © 2025 Lai, Yang, Zhang, Zhang, Liu, Piao, Yan, Shi, Yang, Chen, Zhu, He, Wu, Qian, Lin and Feng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chun-jin Lai, Dongguan Taixin Hospital, Dongguan, China
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