Effects of triiodothyronine supplementation after myocardial ischemia

Dyke, Cornelius M.; Ding, Mai; Abd‐Elfattah, Anwar S.; Loesser, Kathryn E.; Dignan, Rebecca; Wechsler, Andrew S.; Salter, David

doi:10.1016/0003-4975(93)91150-l

Cited by 42 publications

(18 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This rapid response is of great relevance to cardiac surgery [39][40][41]. This rapid recovery was also observed after inducing myocardial stunning in dogs [20].…”

Section: Discussionmentioning

confidence: 84%

Impact of Triiodothyronine on the Survival of High-Risk Patients Undergoing Open Heart Surgery

Novitzky¹,

Fontanet²,

Snyder

et al. 1996

Cardiology

View full text Add to dashboard Cite

Experimental and clinical studies have shown the beneficial effects of triiodothyronine (T₃) following myocardial revascularization on cardiopulmonary bypass (CPB). In this study, open-label T₃ was administered to 68 high-risk patients undergoing open heart surgery. The New Jersey Risk Assessment was used to calculate the preoperative estimated surgical mortality. A loading dose of T₃ was administered: (a) at release of the aortic cross-clamp, (b) whenever the patient became CPB dependent, (c) if the patient exhibited low cardiac output after discontinuing CPB and (d) as pretreatment before initiating CPB. All therapeutic modalities were followed by a continuous T₃ infusion. Following T₃ therapy, CPB was discontinued in all patients. Based upon discriminant analysis, a total of 26 deaths were expected from the entire group, but only 7 patients died, therefore, the observed mortality was reduced by 72% (p < 0.007). The use of T₃ had a major impact on reducing surgical mortality, and may be advocated as a new therapeutic modality in patients with high estimated mortality undergoing open heart surgery.

show abstract

“…This rapid response is of great relevance to cardiac surgery [39][40][41]. This rapid recovery was also observed after inducing myocardial stunning in dogs [20].…”

Section: Discussionmentioning

confidence: 84%

Impact of Triiodothyronine on the Survival of High-Risk Patients Undergoing Open Heart Surgery

Novitzky¹,

Fontanet²,

Snyder

et al. 1996

Cardiology

View full text Add to dashboard Cite

show abstract

“…It has long been observed that administration of TH at reperfusion can improve post-ischemic left ventricular function in animal models of ischemia-reperfusion and in patients undergoing GABG [118][119][120][121][122][123][124][125] (Fig. 7).…”

Section: Th Limits Reperfusion Injurymentioning

confidence: 95%

New insights into the role of thyroid hormone in cardiac remodeling: time to reconsider?

2010

View full text Add to dashboard Cite

Chronic ischemia or pressure overload decreases thyroid hormone (TH) signaling and activates the fetal gene program in the heart. While these features are of physiologic importance in the developing heart, their respective roles in the postnatal heart are debated. Administration of TH can prevent the changes of the fetal gene program and rebuild the heart after an "index event" such as ischemia. TH affects cardiac remodeling by limiting reperfusion injury, and, at later states, by inducing distinct changes in cardiac chamber geometry in a time-dependent manner. Furthermore, administration of TH can convert pathologic to physiologic hypertrophy. These effects are the result of favorable cellular remodeling. While preliminary clinical studies provide encouraging results, the potential and efficacy of TH in the treatment of heart disease still await evaluation in large clinical trials.

show abstract

“…Experiments done by Novitzky et al [25,26] and Dyke et al [27] could demonstrate a beneficial effect of T3 admin istration on myocardial performance after CPB. To fur ther evaluate this effect of T3 administration randomized and blinded trials have to be done.…”

Section: Influence O F Iodine Contamination On Thyroid Functionmentioning

confidence: 99%

Influence of Coronary Artery Bypass Surgery on Thyroid Hormone Parameters

Reinhardt¹,

Mocker²,

Jockenhövel³

et al. 1997

Horm Res

View full text Add to dashboard Cite

The postoperative period after cardiac surgery with cardiopulmonary bypass (CPB) is associated with a low T3 syndrome, i.e. low T3 and fT3 concentrations in the presence of normal T4 and TSH concentrations. So far, results from studies evaluating thyroid function during and after CPB are rather conflicting. We therefore evaluated prospectively thyroid function in 28 patients before, during and up to 3 days after coronary artery bypass surgery. We could demonstrate the most significant changes in thyroid hormone concentrations on day 1 after CPB (low T3 and fT3 concentrations, elevated rT3 concentrations in the presence of a significant fall of TSH). T3 fell from 1.93 to 0.6 nmol/l and fT3 from 5.5 to 1.42 pmol/l. Those patients with low cardiac output syndrome after surgery had significantly lower T3 concentrations than patients without this complication. Moreover, those patients, who already had significant lower T3 values prior to CPB, also demonstrated low T3 concentrations on day 1 after CPB. Cortisol usually has a suppressive effect on TSH secretion. However, the effect of cortisol on TSH in patients undergoing CPB seems to be not that important: those patients with high endogenous cortisol concentrations on day 1 after CPB had similar TSH values to those patients with only slightly elevated cortisol concentrations. Also, the application of high doses of catecholamines seems to have only minor effects on TSH secretion, because those patients requiring high doses of dopamine over a prolonged time period had essentially the same TSH values after CPB. Patients who had been exposed preoperatively to high doses of iodine did not demonstrate significantly different thyroid hormone concentrations. In conclusion: We could demonstrate that CPB induces a low T3 syndrome up to 3 days after surgery. Those patients with low T3 concentrations prior to surgery demonstrate postoperatively a more severe degree of nonthyroidal illness (NTI).Catecholamines and cortisol seem to have only minor effects on the TSH secretion after CPB. The influence of a previous iodine contamination is negligible.

show abstract

Effects of triiodothyronine supplementation after myocardial ischemia

Cited by 42 publications

References 27 publications

Impact of Triiodothyronine on the Survival of High-Risk Patients Undergoing Open Heart Surgery

Impact of Triiodothyronine on the Survival of High-Risk Patients Undergoing Open Heart Surgery

New insights into the role of thyroid hormone in cardiac remodeling: time to reconsider?

Influence of Coronary Artery Bypass Surgery on Thyroid Hormone Parameters

Contact Info

Product

Resources

About