Hypothyroidism as a factor of heart failure in elderly people

Uvod: Cilj ovog rada je ispitivanje povezanosti hipotireoze sa pojavom srčane insuficijencije kod osoba starije životne dobi i utvrđivanje posebnosti uticaja hipotireoze na način prezentovanja i način lečenja srčane insuficijencije kod osoba starije životne dobi. Metod: Ispitivanje je obuhvatalo 277 pacijenata životne dobi 65 godina i preko, a koji su imali dijagnostikovanu srčanu insuficijenciju. Ispitivana grupa su osobe starije životne dobi sa srčanom insuficijencijom i hipotireozom i kontrolna grupa – osobe starije životne dobi sa srčanom insuficijencijom, ali bez hipotireoze hospitalizovani na kliničkom odeljenju za gerijatriju, Kliničko bolničkog centra Zvezdara u Beogradu u periodu od 2005. Do 2010. godine. Ispitivanje je sprovedeno u skladu sa Helsinškom dekleracijom (revidirana verzija, 1983. godina), a odobrena je od strane etičkog komiteta Medicinskog fakulteta Univeziteta u Beogradu. Svi podaci su obrađeni i prikazani merama deskriptivne staristike. Za poređenje kontinuiranih numeričkih varijabli sa normalnom raspodelom korišćen je t-test., dok je poređenje učestalosti korišćen hi-kvadrat. Nivo statističke značajnosti je bio p<0,05. Rezultati: Prosečna starost u grupi ispitanika je bila 80,35+-6,31, a u kontrolnoj grupi 81,41+-6,34 godina. U grupi sa hipotireozom statistički značajno je češća bila pojava angine pektoris (p<0,001). U istoj grupi bilo je statistički više bolesnika sa predhodnom zamenom veštačke valvule (p=0,022). U ispitivanoj grupi starijih bolesnika sa srčanom insuficijencijom i hipotireozom, u odnosu na kontrolnu grupu, registruju se statistički više vrednosti serumskog ukupnog holesterola (p<0,001), LDL-holesterola (p<0,001) i triglicerida (p<0,001). U odnosu na tiroidni hormonski status, na početku studije u ispitivanoj grupi bolesnici sa SI i hipotireozom su imali signifikantno veće vrednosti serumskog TSH (p<0,001) i fT4 (p<0,048) u odnosu na kontrolnu grupu. Posle godinu dana praćenja, nije bilo više razlike u odnosu na vrednosti TSH, dok statistički značajna razlika ostaje u odnosu na serumske vrednosti fT4 (p<0,001). Tokom pet godina praćenja, broj hospitalizacija je bio signifikantno veći u grupi starijih bolesnika sa srčanom insuficijencijom i hipotireozom u odnosu na kontrolnu grupu (p<0,008). Od specifičnih kliničkih parametara ,u ispitivanoj grupi statistički je češće registrovan: subjektivni osećaj gušenja (p<0,009), nalaz bazalnih pukota (p<0,001), otoka nogu (p<0,004) , ST-T EKG promena apsolutne aritmije, veći broj bolesnika sa NYHA III ili IV klasom (p<0,004), bolesnika sa EF <45%, hipertrofija miokarda LK i perikardni izliv. Učestalost umrlih je bila statistički značajno veća u ispitivanoj grupi (p<0,001). Zaključak: Polazeći od poznatih činjenica da hormoni štitne žlezde utiču na rad kardiovaskularnog sistema sa jedne strane, a sa druge strane da i sama starost utiče kako na pojavu srčane insuficijencije tako i slabije funkcije štitne žlezde, u starijoj životnoj populaciji u prisustvu hipotireoze, hronična srčana insuficijencija ima lošiju prognozu, sa češćim smnrtnim ishodom, sa većim brojem NYHA III i IV klase bolesnika, manjom EF, većim brojem hospitalizacija, češćom pojavom angine pektoris, višim serumskim vrednostima ureje, kreatinina, kao i holesterola i triglicerida.INTRODUCTION: The aim of this work was to investigate the association of hypothyroidism with the emergence of heart failure in elderly people and determining the specific influence of hypothyroidism in the manner of presentation and method of treating heart failure in the elderly. METHOD: Testing has included 277 patients aged 65 years and over, who had a diagnosed heart failure. The study groups are the elderly with heart failure and hypothyroidism and control groups - elderly people with heart failure, but without clinical hypothyroidism hospitalized at the geriatric ward of the Clinical Center Zvezdara in Belgrade in the period since 2005. By 2010 the study was conducted in accordance with the Declaration of Helsinki (revised version, 1983 years) and has been approved by the ethical committee of the Medical Faculty of the University of Belgrade. All data are analyzed and presented measures of descriptive statistics. For comparison of continuous numerical variables with normal distribution was used t-test, while the comparison frequency used chi-square. Level of significance was p <0.05. Results: The average age in the group of respondents was 80.35 + -6.31, and in the control group 81.41 + -6.34 years. In the group with hypothyroidism was significantly more frequent occurrence of angina pectoris (p <0.001). In the same group was statistically higher in patients with previous prosthetic valve replacement (p = 0.022). In the study group of elderly patients with heart failure and hypothyroidism, compared to the control group, registered a statistically higher serum total cholesterol (p <0.001), LDL-cholesterol (p <0.001) and triglycerides (p <0.001). In relation to thyroid hormone status at baseline in the study group patients with SI and hypothyroidism had significantly higher serum TSH (p <0.001) and FT4 (p <0.048) compared to the control group. After a year of follow-up, there were more differences to TSH, while statistically significant difference remains in relation to serum fT4 (p <0.001). During five years of follow up, the number of hospitalizations was significantly higher in the group of elderly patients with heart failure and hypothyroidism compared to the control group (p <0.008). Of specific clinical parameters in the study group was statistically more frequently registered a subjective feeling of suffocation (p <0.009), a finding basal crackles (p <0.001), when legs (p <0.004), ST-T changes in ECG were arrhythmia, a larger number of patients with NYHA class III or IV (p <0.004), patients with EF <45%, LK hypertrophy and pericardial effusion. The incidence of deaths was significantly higher in the study group (p <0.001). Conclusion: Starting from the known fact that thyroid hormones affect the cardiovascular system on the one hand, and on the other side how age affects the occurrence of heart failure and poor thyroid function in the elderly population in the presence of hypothyroidism, chronic heart failure has worse prognosis, with a more frequent fatal outcome, with a number of NYHA class III and IV patients, lower EF, a larger number of hospitalization, higher incidence of angina pectoris, higher serum levels of urea, creatinine, and cholesterol and triglyceride levels

Identification and characterization of lactic acid bacteria isolated from artisanal white brined Golija cows' milk cheeses

The aim of this study was to identify and characterize the lactic acid bacteria (LAB) of artisanal Golija raw and cooked cows' milk cheeses traditionally manufactured without the addition of starter culture. A total of 188 Gram-positive and catalase-negative isolates of Golija cheeses were obtained from seven samples of different ripening time. Phenotype-based assays as well as rep-PCR and 16S rDNA sequence analysis were undertaken for all 188 LAB strains. The most diverse species were isolated from 20-day-old BGGO8 cheese (Lactobacillus fermentum, Lactobacillus plantarum, Lactobacillus casei/paracasei, Lactobacillus sucicola, Lactococcus lactis subsp. lactis, Lactococcus lactis subsp. lactis by. diacetylactis, Enterococcus faecium, Enterococcus durans and Leuconostoc mesenteroides). In other Golija cheeses Lactobacillus reuteri, Lactobacillus curvatus, Lactobacillus rhamnosus, Lactococcus lactis subsp. cremoris, Lactococcus garvieae, Streptococcus thermophilus and Leuconostoc pseudomesenteroides were found. Pronounced antimicrobial properties showed enterococci (13/42) and lactococci (12/31), while the good proteolytic activity demonstrated lactococci (13/31) and lactobacilli (10/29)

Forensic Fractal Nature Applications

Fractals are fragmented geometric shapes based on each or parts self-similarity. Fractal dimension (FD) is the most important characteristics in fractal nature analysis. There are many fractals applications including the forensic photography. The fractals image reconstruction is very important for modern forensic science. Here we demonstrate the very new original fractal applications in forensic sciences. This is a quite new application in crime investigations specifically in latent fingerprinting within biometric analysis. All of these open a new frontier in falsificates, financial and generally economic crime scene areas

Microstructure assessment of Co alloy intended for dentistry

Cobalt–chromium–molybdenum (CoCrMo) alloys are known for medical use due to their biocompatibility, corrosion and wear resistance. The chemical and phase composition, as well as microstructure of the alloy directly affect the mechanical properties. In this investigation, CoCrMo alloy samples were obtained by vacuum precise casting. The procedure of melting and casting process as well as their parameters are given. Molds fabricated of copper, gray iron, steel, ceramics and graphite were used during the casting process. In this way, the cooling rate influence on the obtained microstructure was examined. Besides, different casting temperatures (1400°C, 1450°C and 1500°C) were applied for each kind of mold. After metallographic preparation, the microstructure was examined on the cross section of samples by optical microscopy. The obtained results show that by increasing the cooling rate, the microstructure of samples become finer and more homogeneous

Mathematical modeling for genomic selection in Serbian dairy cattle

Mathematical modeling for genomic selection in serbian dairy cattle. - Genetika, Vol 53, No.3, 1105-1115. This manuscript has come as a result of an efficient breeding program in Serbian cattle populations for some economically important traits. Genomic selection in the last two decades has been the main challenge in animal breeding programs and genetics. Many SNP markers are used in statistical analysis in predicting the accuracy of breeding values for young animals without their performance. The new breeding tendency in the selection of young animals allows their genetic progress with reducing cost. In this study, 92 Holstein cows from various regions in Serbia were analyzed based on SNP molecular markers. Within this investigation, an empirical model was developed for the prediction of Yield Traits and Fertility Traits variables, according to Key traits data for dairy cattle. The developed model gave a reasonable fit to the data and successfully predicted Yield Traits (such as Fat and Protein Percent, Cheese Merit, Fluid Merit, and Cow Livability) and Fertility Traits variables (such as Sire Calving Ease, Heifer Conception Rate, Cow Conception Rate, Daughter Stillbirth, Sire Stillbirth, and Gestation Length). A total of 92 dairy cattle data were used to build a prediction model for the prediction of Yield Traits and Fertility Traits variables. The artificial neural network model, based on the Broyden-Fletcher-Goldfarb-Shanno iterative algorithm, showed good prediction capabilities (the r2 values during the training cycle for the before mentioned output variables were in the range between 0.444 and 0.989)

Health-related quality of life in elderly patients hospitalized with chronic heart failure

Background: Chronic heart failure is a very common condition in the elderly, characterized not only by high mortality rates, but also by a strong impact on health-related quality of life (HRQOL). Previous studies of HRQOL in elderly heart failure subjects have included mostly outpatients, and little is known about determinants of HRQOL in hospitalized elderly population, especially in Serbia. In this study, we tried to identify factors that influence HRQOL in elderly patients hospitalized with chronic heart failure in Serbia. Methods: The study population consisted of 136 patients aged 65 years or older hospitalized for chronic heart failure. HRQOL was assessed using the Minnesota Living with Heart Failure questionnaire. Predictors of HRQOL were identified by multiple linear regression analysis. Results: Univariate analysis showed that patients with lower income, a longer history of chronic heart failure, and longer length of hospital stay, as well as those receiving aldosterone antagonists and digoxin, taking multiple medications, in a higher NYHA class, and showing signs of depression and cognitive impairment had significantly worse HRQOL. Presence of depressive symptoms (P lt 0.001), higher NYHA class (P=0.021), lower income (P=0.029), and longer duration of heart failure (P=0.049) were independent predictors of poor HRQOL. Conclusion: Depressive symptoms, higher NYHA class, lower income, and longer duration of chronic heart failure are independent predictors of poor HRQOL in elderly patients hospitalized with chronic heart failure in Serbia. Further, there is an association between multiple medication usage and poor HRQOL, as well as a negative impact of cognitive impairment on HRQOL. Hence, measures should be implemented to identify such patients, especially those with depressive symptoms, and appropriate interventions undertaken in order to improve their HRQOL

Pedijatrijski nefrotski sindrom: međusobna interakcija oksidativnog stresa i inflamacije

Background: The pathophysiological mechanisms crucial in the development of nephrotic syndrome (NS) in the pediatric population are still not fully understood. This study aimed to investigate the relationship between hypertension, oxidative stress, and inflammation in pediatric patients during the acute phase of the disease. Methods: The study included 33 children, aged 2 to 9 years, with nephrotic syndrome. Blood samples were collected during the acute phase and remission. Parameters of oxidative status were determined, including total oxidative status (TOS), advanced oxidation protein products (AOPP), prooxidant-antioxidant balance (PAB), sulfhydryl groups (- SH), paraoxonase 1 (PON1), and total antioxidant status (TAS) in serum, measured spectrophotometrically. Inflam- matory parameters such as pentraxin 3 (PTX3), leptin, programmed cell death ligand 1 (PD-L1), and E-cadherin were determined using enzyme-linked immunosorbent assay (ELISA). Results: Patients with nephrotic syndrome and hypertension had significantly higher levels of advanced oxidation protein products and total antioxidant status (p=0.029 and p=0.003, respectively). During the acute phase of the dis- ease, lower activity of sulfhydryl groups and paraoxonase 1 was observed compared to remission (p<0.001, for both). Pentraxin 3 levels were higher, while leptin levels were lower during the acute phase (p<0.001, for both). Pentraxin 3 correlated with advanced oxidation protein products and total antioxidant status during the acute phase but not in remission (r s =0.42, p=0.027 and r s =0.43, p=0.025, respectively). A negative correlation between Advanced oxidation protein products and leptin was observed during the acute phase, which disappeared in remission (rs=-0.42, p=0.028). Conclusions: Results of this study show that hypertension influences oxidative stress markers, and decreased antioxi- dant capacity may contribute to nephrotic syndrome devel- opment. Pentraxin 3 appears as a potential disease activity marker, indicating a dynamic connection between inflam- mation and oxidative stress. Leptin may also play a role in oxidative stress in nephrotic syndrome.Uvod: Patofiziološki mehanizmi ključni u razvoju nefrotskog sindroma (NS) u pedijatrijskoj populaciji još uvek nisu u potpunosti razjašnjeni. Ova studija ima za cilj proučavanje sinergističkog delovanja oksidativnog stresa i inflamacije u patogenezi NS. Takođe, jedan od ciljeva ove studije je i ispitivanje veze hipertenzije sa stepenom oksidativnog stresa i inflama - cije kod pacijenata u akutnoj fazi bolesti. Metode: U studiju je uključeno 33 dece sa NS uzrasta od 2 do 9 godina. Uzorci krvi su prikupljeni tokom akutne faze i remisije. Od parametara oksidativnog statusa određivani su: totalni oksidativni status (TOS), uznapredovali proizvodi oksidacije proteina (AOPP), balans prooksidans-antioksidans (PAB), sulfhidrilne grupe (-SH), paraoksonaza 1 (PON1) i ukupan antioksidativni status (TAS) u serumu su mereni spektrofometrijski, a od parametara inflamacije su pentraksin 3 (PTX3), leptin, ligand programirane smrti ćelije 1 (PD-L1) i E-kadherin određivani metodom enzimskog imunosorbentnog testa (ELISA). Rezultati: Pacijenti sa NS i hipertenzijom imali su značajno više nivoe AOPP i TOS (p=0.029 i p=0.003, respektivno). U akutnoj fazi bolesti su uočene nižu aktivnost -SH i PON1 u poređenju sa remisijom (p<0.001, za oba). Nivoi PTX 3 su bili viši, dok su nivoi leptina bili niži tokom akutne faze (p<0.001, za oba). PTX 3 je korelirao sa AOPP i TAS u akutnoj fazi, ali ne i u remisiji (rs=0.42, p=0.027 i rs=0.43, p=0.025,respektivno). U akutnooj fazi utvrđena je negativna korelacija između AOPP i leptina, koja je nestala u remisiji (rs=-0.42, p=0.028). Zaključak: Rezultati ove studije ukazuju da hipertenzija utiče na markere oksidativnog stresa, a smanjeni antioksidativni kapacitet može doprineti razvoju NS. PTX3 se pojavljuje kao potencijalni marker aktivnosti bolesti, što ukazuje na dinamičku vezu između inflamacije i oksidativnog stresa. Leptin može igrati ulogu u oksidativnom stresu u NS

Water for all : Proceedings of the 7th international scientific and professional conference Water for all

The 7th International Scientific and Professional Conference Water for all is organized to honour the World Water Day by the Josip Juraj Strossmayer University of Osijek, European Hygienic Engineering & Design Group (EHEDG), Danube Parks, Croatian Food Agency, Croatian Water, Faculty of Food Technology Osijek, Faculty of Agriculture in Osijek, Faculty of Civil Engineering Osijek, Josip Juraj Strossmayer University of Osijek Department of Biology, Josip Juraj Strossmayer University of Osijek Department of Chemistry, Nature Park “Kopački rit”, Osijek- Baranja County, Public Health Institute of the Osijek- Baranja County and „Vodovod-Osijek“ -water supply company in Osijek. The topic of World Water Day 2017 was "Wastewater" emphasizing the importance and influence of wastewater treatments on global environment. The international scientific and professional conference Water for all is a gathering of scientists and experts in the field of water management, including chemists, biologists, civil and agriculture engineers, with a goal to remind people about the significance of fresh water and to promote an interdisciplinary approach and sustainability for fresh water resource management. The Conference has been held since 2011. About 300 scientists and engineers submitted 95 abstracts to the 7th International Scientific and Professional Conference Water for all, out of which 33 was presented orally and 62 as posters. 47 full papers were accepted by the Scientific Committee. 38 full papers became the part of the this Proceedings while 9 papers were accepted for publication in Croatian Journal of Food Science and Technology and Electronic Journal of the Faculty of Civil Engineering Osijek - e-GFOS

Izzivi neravnovesja med rastjo outputa in zaposlenosti v tranzicijskih gospodarstvih

The trade-off between output and unemployment has become an essential part of modern macroeconomics and is known as Okun’s law. However, in transition and emerging markets economies’ context, the output-employment nexus has a much more important role as these countries strive to significantly improve the growth dynamics of both variables. This paper aims to analyze the particularities of this relationship in selected Central- and South-Eastern European transition (and former transition) countries to find out a discrepancy between the output and employment growth. Therefore, the employment elasticity coefficients are calculated. The estimated results suggest that, in the observed period, economic growth has not contributed to satisfactory employment growth, which is commonly referred to as a “jobless growth” hypothesis. Accordingly, this paper attempts to single out the main challenges of the output-employment growth misbalance in these countries and propose adequate policy measures that could reduce it. The industrial policy that differentiates from the “one-size-fits-all” paradigm is emphasized as the most important part of macroeconomic policy in transition economies to make their development more balanced. Additionally, short-run stabilization policy, especially the one focused on the labour market, has a significant role in these economies

Hypothyroidism as a factor of heart failure in elderly people

Uvod: Cilj ovog rada je ispitivanje povezanosti hipotireoze sa pojavom srčane insuficijencije kod osoba starije životne dobi i utvrđivanje posebnosti uticaja hipotireoze na način prezentovanja i način lečenja srčane insuficijencije kod osoba starije životne dobi. Metod: Ispitivanje je obuhvatalo 277 pacijenata životne dobi 65 godina i preko, a koji su imali dijagnostikovanu srčanu insuficijenciju. Ispitivana grupa su osobe starije životne dobi sa srčanom insuficijencijom i hipotireozom i kontrolna grupa – osobe starije životne dobi sa srčanom insuficijencijom, ali bez hipotireoze hospitalizovani na kliničkom odeljenju za gerijatriju, Kliničko bolničkog centra Zvezdara u Beogradu u periodu od 2005. Do 2010. godine. Ispitivanje je sprovedeno u skladu sa Helsinškom dekleracijom (revidirana verzija, 1983. godina), a odobrena je od strane etičkog komiteta Medicinskog fakulteta Univeziteta u Beogradu. Svi podaci su obrađeni i prikazani merama deskriptivne staristike. Za poređenje kontinuiranih numeričkih varijabli sa normalnom raspodelom korišćen je t-test., dok je poređenje učestalosti korišćen hi-kvadrat. Nivo statističke značajnosti je bio p<0,05. Rezultati: Prosečna starost u grupi ispitanika je bila 80,35+-6,31, a u kontrolnoj grupi 81,41+-6,34 godina. U grupi sa hipotireozom statistički značajno je češća bila pojava angine pektoris (p<0,001). U istoj grupi bilo je statistički više bolesnika sa predhodnom zamenom veštačke valvule (p=0,022). U ispitivanoj grupi starijih bolesnika sa srčanom insuficijencijom i hipotireozom, u odnosu na kontrolnu grupu, registruju se statistički više vrednosti serumskog ukupnog holesterola (p<0,001), LDL-holesterola (p<0,001) i triglicerida (p<0,001). U odnosu na tiroidni hormonski status, na početku studije u ispitivanoj grupi bolesnici sa SI i hipotireozom su imali signifikantno veće vrednosti serumskog TSH (p<0,001) i fT4 (p<0,048) u odnosu na kontrolnu grupu. Posle godinu dana praćenja, nije bilo više razlike u odnosu na vrednosti TSH, dok statistički značajna razlika ostaje u odnosu na serumske vrednosti fT4 (p<0,001). Tokom pet godina praćenja, broj hospitalizacija je bio signifikantno veći u grupi starijih bolesnika sa srčanom insuficijencijom i hipotireozom u odnosu na kontrolnu grupu (p<0,008). Od specifičnih kliničkih parametara ,u ispitivanoj grupi statistički je češće registrovan: subjektivni osećaj gušenja (p<0,009), nalaz bazalnih pukota (p<0,001), otoka nogu (p<0,004) , ST-T EKG promena apsolutne aritmije, veći broj bolesnika sa NYHA III ili IV klasom (p<0,004), bolesnika sa EF <45%, hipertrofija miokarda LK i perikardni izliv. Učestalost umrlih je bila statistički značajno veća u ispitivanoj grupi (p<0,001). Zaključak: Polazeći od poznatih činjenica da hormoni štitne žlezde utiču na rad kardiovaskularnog sistema sa jedne strane, a sa druge strane da i sama starost utiče kako na pojavu srčane insuficijencije tako i slabije funkcije štitne žlezde, u starijoj životnoj populaciji u prisustvu hipotireoze, hronična srčana insuficijencija ima lošiju prognozu, sa češćim smnrtnim ishodom, sa većim brojem NYHA III i IV klase bolesnika, manjom EF, većim brojem hospitalizacija, češćom pojavom angine pektoris, višim serumskim vrednostima ureje, kreatinina, kao i holesterola i triglicerida.INTRODUCTION: The aim of this work was to investigate the association of hypothyroidism with the emergence of heart failure in elderly people and determining the specific influence of hypothyroidism in the manner of presentation and method of treating heart failure in the elderly. METHOD: Testing has included 277 patients aged 65 years and over, who had a diagnosed heart failure. The study groups are the elderly with heart failure and hypothyroidism and control groups - elderly people with heart failure, but without clinical hypothyroidism hospitalized at the geriatric ward of the Clinical Center Zvezdara in Belgrade in the period since 2005. By 2010 the study was conducted in accordance with the Declaration of Helsinki (revised version, 1983 years) and has been approved by the ethical committee of the Medical Faculty of the University of Belgrade. All data are analyzed and presented measures of descriptive statistics. For comparison of continuous numerical variables with normal distribution was used t-test, while the comparison frequency used chi-square. Level of significance was p <0.05. Results: The average age in the group of respondents was 80.35 + -6.31, and in the control group 81.41 + -6.34 years. In the group with hypothyroidism was significantly more frequent occurrence of angina pectoris (p <0.001). In the same group was statistically higher in patients with previous prosthetic valve replacement (p = 0.022). In the study group of elderly patients with heart failure and hypothyroidism, compared to the control group, registered a statistically higher serum total cholesterol (p <0.001), LDL-cholesterol (p <0.001) and triglycerides (p <0.001). In relation to thyroid hormone status at baseline in the study group patients with SI and hypothyroidism had significantly higher serum TSH (p <0.001) and FT4 (p <0.048) compared to the control group. After a year of follow-up, there were more differences to TSH, while statistically significant difference remains in relation to serum fT4 (p <0.001). During five years of follow up, the number of hospitalizations was significantly higher in the group of elderly patients with heart failure and hypothyroidism compared to the control group (p <0.008). Of specific clinical parameters in the study group was statistically more frequently registered a subjective feeling of suffocation (p <0.009), a finding basal crackles (p <0.001), when legs (p <0.004), ST-T changes in ECG were arrhythmia, a larger number of patients with NYHA class III or IV (p <0.004), patients with EF <45%, LK hypertrophy and pericardial effusion. The incidence of deaths was significantly higher in the study group (p <0.001). Conclusion: Starting from the known fact that thyroid hormones affect the cardiovascular system on the one hand, and on the other side how age affects the occurrence of heart failure and poor thyroid function in the elderly population in the presence of hypothyroidism, chronic heart failure has worse prognosis, with a more frequent fatal outcome, with a number of NYHA class III and IV patients, lower EF, a larger number of hospitalization, higher incidence of angina pectoris, higher serum levels of urea, creatinine, and cholesterol and triglyceride levels