Hyperthyroidism-induced dilated cardiomyopathy

Chariyawong, Phumpattra; Rao, Angela; Panikkath, Deepa; Panikkath, Ragesh

doi:10.12746/swrccc.v7i27.526

Cited by 4 publications

(5 citation statements)

References 8 publications

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“…It is crucial to recognize DCM as a potentially reversible and unusual manifestation in patients with thyrotoxicosis patient [241]. Excess thyroxine centrally stimulates activity in the sympathetic nervous system by positively regulating β1-adrenergic receptors and upregulating sarcoplasmic reticulum Ca 2+ ATPase, which is involved in excitationcontraction coupling and calcium-induced calcium release [257]. Calcium released from the ryanodine receptor in the sarcoplasmic reticulum activates the myocardial myofilaments, leading to positive inotropy [257].…”

Section: Discussionmentioning

confidence: 99%

Data Analysis and Systematic Scoping Review on the Pathogenesis and Modalities of Treatment of Thyroid Storm Complicated with Myocardial Involvement and Shock

Elmenyar,

Aoun,

Al Saadi

et al. 2023

Diagnostics

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Thyroid storm (TS) is a rare and fatal endocrine emergency that occurs due to undiagnosed and inadequately treated hyperthyroidism after stressful conditions in patients with thyroid disorders. The objective of this systematic scoping review was to better understand the pathophysiology of TS and its complications, in terms of myocardial affection, tachyarrhythmia, and cardiogenic shock. In addition, we explored the pharmacological, mechanical, and surgical treatments for TS. We also evaluated the outcomes of TS according to sex and cardiac involvement. Additionally, analytical analysis was performed on the selected data. A literature review of peer-reviewed journals was carried out thoroughly using medical terms, MeSH on PubMed, Google Scholar, and combinations such as thyrotoxicosis-induced cardiomyopathy, thyroid storm, cardiogenic shock, myocardial infarction, endocrine emergency, Burch–Wartofsky score, extracorporeal circulatory support, and thyroidectomy. A total of 231 papers were eligible (2 retrospective studies, 5 case series, and 224 case reports) with a total of 256 TS patients with cardiac involvement between April 2003 and August 2023. All age groups, sexes, patients with TS-induced cardiomyopathy, non-atherosclerotic myocardial infarction, tachyarrhythmia, heart failure, shock, and different forms of treatment were discussed. Non-English language articles, cases without cardiac involvement, and cases in which treatment modalities were not specified were excluded. Female sex was predominant, with 154 female and 102 male patients. Approximately 82% of patients received beta-blockers (BBs), 16.3% were placed on extracorporeal membrane oxygenation (ECMO) support, 16.3% received therapeutic plasma exchange (TPE), and 13.8% underwent continuous renal replacement therapy (CRRT), continuous venovenous hemofiltration (CVVHD), or dialysis. Overall, 18 females and 16 males died. BB-induced circulatory collapse, acute renal failure, CRRT, and ventricular fibrillation were significantly associated with mortality. Awareness of TS and not only thyrotoxicosis is vital for timely and appropriate treatment. The early diagnosis and management of TS in cardiac settings, including pharmacological, mechanical, and surgical modalities, can save high-risk patients. Sex matters in the presentation, treatment, and mortality of this population. However, further large-scale, and well-designed studies are required.

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Section: Discussionmentioning

confidence: 99%

Data Analysis and Systematic Scoping Review on the Pathogenesis and Modalities of Treatment of Thyroid Storm Complicated with Myocardial Involvement and Shock

Elmenyar,

Aoun,

Al Saadi

et al. 2023

Diagnostics

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“… 26 In a small percentage, dilation of all four chambers and reduced systolic function can be seen. 44 , 45 …”

Section: Diagnosismentioning

confidence: 99%

Thyrotoxic Cardiomyopathy: State of the Art

Quiroz-Aldave¹,

Durand-Vásquez²,

Lobato-Jeri³

et al. 2023

European Endocrinology

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Thyroid hormones, mainly triiodothyronine, have genomic and non-genomic effects on cardiomyocytes related to the contractile function of the heart. Thyrotoxicosis, which is the set of signs and symptoms derived from the excess of circulating thyroid hormones, leads to increased cardiac output and decreased systemic vascular resistance, increasing the volume of circulating blood and causing systolic hypertension. In addition, the shortening of the refractory period of cardiomyocytes produces sinus tachycardia and atrial fibrillation. This leads to heart failure. Approximately 1% of patients with thyrotoxicosis develop thyrotoxic cardiomyopathy, a rare but potentially fatal form of dilated cardiomyopathy. Thyrotoxic cardiomyopathy represents a diagnosis of exclusion, and prompt identification is crucial as it is a reversible cause of heart failure, and heart function can be recovered after achieving a euthyroid state using antithyroid drugs. Radioactive iodine therapy and surgery are not the best initial therapeutic approach. Moreover, it is important to manage cardiovascular symptoms, for which beta blockers are the first-line therapeutic option.

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“…Cardiomyopathy associated with hyperthyroidism is not unique, and mostly mimics cardiac hypertrophy or in rare cases, DCM. 63 64 65 T 3 is a key regulator of cardiac physiology that also modulates sphingolipid metabolism. Prolonged treatment with T 3 led to a prominent increase of DHS, sphingosine, ceramide and SM levels, but decreased S1P levels, in cardiomyocytes taken from the LV of male mice.…”

Section: Sphingolipids In Secondary Cardiomyopathiesmentioning

confidence: 99%

Sphingolipid Mediators of Myocardial Pathology

Kovilakath

Cowart

2020

J Lipid Atheroscler

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Cardiomyopathy is the leading cause of mortality worldwide. While the causes of cardiomyopathy continue to be elucidated, current evidence suggests that aberrant bioactive lipid signaling plays a crucial role as a component of cardiac pathophysiology. Sphingolipids have been implicated in the pathophysiology of cardiovascular disease, as they regulate numerous cellular processes that occur in primary and secondary cardiomyopathies. Experimental evidence gathered over the last few decades from both in vitro and in vivo model systems indicates that inhibitors of sphingolipid synthesis attenuate a variety of cardiomyopathic symptoms. In this review, we focus on various cardiomyopathies in which sphingolipids have been implicated and the potential therapeutic benefits that could be gained by targeting sphingolipid metabolism.

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Hyperthyroidism-induced dilated cardiomyopathy

Cited by 4 publications

References 8 publications

Data Analysis and Systematic Scoping Review on the Pathogenesis and Modalities of Treatment of Thyroid Storm Complicated with Myocardial Involvement and Shock

Data Analysis and Systematic Scoping Review on the Pathogenesis and Modalities of Treatment of Thyroid Storm Complicated with Myocardial Involvement and Shock

Thyrotoxic Cardiomyopathy: State of the Art

Sphingolipid Mediators of Myocardial Pathology

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