Prospective Echocardiographic Evaluation of the Right Ventricle and Pulmonary Arterial Pressure in Hyperthyroid Patients

Gazzana, Maria Luiza; Souza, Jean Jorge Silva de; Okoshi, Marina Politi; Okoshi, Katashi

doi:10.1016/j.hlc.2018.06.1055

Cited by 10 publications

(16 citation statements)

References 27 publications

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“…The examinations were performed by the same examiner (an experienced cardiologist), who did not know which of the previously established groups the animals belonged to. The method was previously set in our group [ 16 , 17 ].…”

Section: Methodsmentioning

confidence: 99%

Green Tea (Camellia sinensis) Extract Increased Topoisomerase IIβ, Improved Antioxidant Defense, and Attenuated Cardiac Remodeling in an Acute Doxorubicin Toxicity Model

Modesto

Polegato

Santos

et al. 2021

Oxidative Medicine and Cellular Longevity

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Experimental studies have shown the action of green tea in modulating cardiac remodeling. However, the effects of green tea on the cardiac remodeling process induced by doxorubicin (DOX) are not known. Therefore, this study is aimed at evaluating whether green tea extract could attenuate DOX-induced cardiac remodeling, assessed by cardiac morphological and functional changes and associated with the evaluation of different modulators of cardiac remodeling. The animals were divided into four groups: the control group (C), the green tea group (GT), the DOX group (D), and the DOX and green tea group (DGT). Groups C and GT received intraperitoneal sterile saline injections, D and DGT received intraperitoneal injections of DOX, and GT and DGT were fed chow supplemented with green tea extract for 35 days prior to DOX injection. After forty-eight hours, we performed an echocardiogram and euthanasia and collected the materials for analysis. Green tea attenuated DOX-induced cardiotoxicity by increasing cardiac function and decreasing the concentric remodeling. Treatment with DOX increased oxidative stress in the heart, marked by a higher level of lipid hydroperoxide (LH) and lower levels of antioxidant enzymes. Treatment with green tea increased the antioxidant enzymes’ activity and decreased the production of LH. Green tea extract increased the expression of Top2-β independent of DOX treatment. The activity of ATP synthase, citrate synthase, and complexes I and II decreased with DOX, without the effects of green tea. Both groups that received DOX presented with a lower ratio of P-akt/T-akt and a higher expression of CD45, TNFα, and intermediate MMP-2, without the effects of green tea. In conclusion, green tea attenuated cardiac remodeling induced by DOX and was associated with increasing the expression of Top2-β and lowering oxidative stress. However, energy metabolism and inflammation probably do not receive the benefits induced by green tea in this model.

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Section: Methodsmentioning

confidence: 99%

Green Tea (Camellia sinensis) Extract Increased Topoisomerase IIβ, Improved Antioxidant Defense, and Attenuated Cardiac Remodeling in an Acute Doxorubicin Toxicity Model

Modesto

Polegato

Santos

et al. 2021

Oxidative Medicine and Cellular Longevity

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“…However, 6 articles were excluded from the review as most of the data were either not available or not extractable. [ 12 , 21 , 24 , 29 – 31 ] Furthermore, 2 articles were in language other than English and 2 were review articles without original data and were removed from the analysis. Forty-two studies with 589 patients were included in the review, comprising 9 retrospective studies, 3 prospective studies, 4 case series, and twenty-six case reports.…”

Section: Resultsmentioning

confidence: 99%

The clinical characteristics and outcomes of patients with pulmonary hypertension in association with hyperthyroid state: A systematic review

et al. 2022

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Background: Pulmonary hypertension (PHTN) may occur in thyroid disorders, especially in hypothyroidism. However, there is increasing evidence of PHTN in hyperthyroidism (HTH). The etiology, clinical course, management, and factors associated with outcomes of PHTN in the setting of HTH are unascertained. This systematic review consolidates available evidence on patients with HTH who developed PHTN. Methods: We conducted a systematic review on English articles from PubMed, Scopus, and Google Scholar reporting PHTN in patients with hyperthyroidism. Data were analyzed and reported in Microsoft Excel 2020, SPSS version 26, and Jamovi version 1.2. Results: We identified 589 patients with PHTN in the setting of HTH. Etiologies included Grave disease 66.7%), toxic multinodular goiter (TMNG) (16.8%), drug-induced HTH (0.3%), thyroiditis(0.8%), and toxic adenoma(0.1%). Most patients did not receive any specific management for PHTN and were managed by antithyroid treatment (97.4%). Outcomes of PHTN were reported in 181 patients, with a 94% recovery rate. Pulmonary artery pressures (PAP) before and after HTH management ranged from 22.5 to 75 mm Hg and from 24 to 50 mm Hg, respectively. Outcome analysis performed on data from case reports and series with individually identifiable data revealed a 67.6% female preponderance. An estimated 73.5% of the patients had PHTN at the initial presentation of HTH, which was associated with a better resolution rate of PHTN(OR: 12, P -value: 0.048). TRAB was positive in 47% patients with no clinical difference in outcomes. antiTG AB was reported positive in 29.4%, all of whom had an improvement, compared to an 83.3% improvement rate in those with negative antiTG AB. Various etiologies and treatments did not have any significant differences in the outcome of PHTN. Conclusions: PHTN can be present at the initial diagnosis of HTH, which is associated with better outcomes of PHTN. There is a clear female preponderance in the development of PHTN. However, resolution rates seem to be better in males. Although TRAB is associated with the development of PHTN, it does not seem to affect the outcomes. PHTN in patients with HTH does not need any specific management, with >90% resolution with antithyroid therapy. Whether any specific antithyroid therapy has a better outcome in PHTN needs to be explored prospectively.

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“…It was concluded that patients with hyperthyroidism developed cardiovascular changes, increased cardiac chamber size, cardiac output, left ventricular ejection fraction (LVEF), and pulmonary artery systolic pressure. These changes were evidenced to be reversible after lowering the levels of FT4 back to normal in patients without the pre-existing cardiovascular disease (Table 4) [46].…”

Section: Treatment Of Heart Failure In Thyrotoxicosismentioning

confidence: 99%

“…After weekly monitoring FT4, FT3, TSH, and thyrotropin-binding inhibitory immunoglobulin, it was concluded that cholestyramine is most effective in treating thyrotoxicosis during the first few weeks of treatment [59]. Last, prevention against systemic decompensation can be done via acetaminophen to prevent hyperthermia and dextrose and electrolytes to prevent dehydration [46]. Hyperthyroidism has a significant clinical impact as it affects cardiac morphology and function.…”

Section: Treatment Of Heart Failure In Thyrotoxicosismentioning

confidence: 99%

Cardiovascular Involvement in Thyrotoxicosis Resulting in Heart Failure: The Risk Factors and Hemodynamic Implications

Raguthu¹,

Gajjela²,

Kela³

et al. 2022

Cureus

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Thyrotoxicosis is a clinical syndrome with persistently elevated concentrations of free triiodothyronine, free thyroxine, or both, which correlates with an increased thyroid metabolic function. This article has discussed the direct effect of increased thyroid hormone on the heart, as the thyroid hormone physiologically exhibits a close harmony with hormones of the cardiovascular system. This action can lead to disturbances in hemodynamic stability, exacerbating the possibility of developing complications such as heart failure and life-threatening arrhythmias. This article has also explored the multifaceted pathogenesis of thyrotoxicosis and various pharmacological treatment options, including beta-blockers and anti-thyroid drugs. This article has reviewed numerous studies that have concluded that the main goal of therapy should always aim to normalize thyroid hormone levels based on the etiology of the thyrotoxicosis, although cardiovascular conditions are associated with a higher rate of mortality.

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Prospective Echocardiographic Evaluation of the Right Ventricle and Pulmonary Arterial Pressure in Hyperthyroid Patients

Cited by 10 publications

References 27 publications

Green Tea (Camellia sinensis) Extract Increased Topoisomerase IIβ, Improved Antioxidant Defense, and Attenuated Cardiac Remodeling in an Acute Doxorubicin Toxicity Model

Green Tea (Camellia sinensis) Extract Increased Topoisomerase IIβ, Improved Antioxidant Defense, and Attenuated Cardiac Remodeling in an Acute Doxorubicin Toxicity Model

The clinical characteristics and outcomes of patients with pulmonary hypertension in association with hyperthyroid state: A systematic review

Cardiovascular Involvement in Thyrotoxicosis Resulting in Heart Failure: The Risk Factors and Hemodynamic Implications

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