The relationship of thyroid hormone status with myocardial function in stress cardiomyopathy

Lee, Seong Jin; Kang, Jun Goo; Ryu, Ohk Hyun; Kim, Chul Sik; Ihm, Sung-Hee; Choi, Moon Gi; Yoo, Hyung Joon; Hong, Kyung Soon

doi:10.1530/eje-08-0808

Cited by 20 publications

(10 citation statements)

References 57 publications

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“…One proposed mechanism for this is the abrupt drop in estrogen levels following delivery, combined with a high physical and emotional stress state (41). However, other studies have found a correlation between lower T3 levels and myocardial contractility in patients with SIC (44). There may be gender-related differences in the autonomic nervous system that may partially explain the higher rates of this condition in women (42).…”

Section: Pathophysiologymentioning

confidence: 99%

Stress-Induced Cardiomyopathy

Boland

Lee

Bleck

2015

Critical Care Medicine

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Section: Pathophysiologymentioning

confidence: 99%

Stress-Induced Cardiomyopathy

Boland

Lee

Bleck

2015

Critical Care Medicine

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“…7 Furthermore, Lee SJ and colleagues showed influence of thyroid autoimmunity on myocardial contractility in stress cardiomyopathy. 8 Our patient had several autoimmune conditions. All these raise questions about relationship between autoimmune disease and pathogenesis of TCM.…”

Section: Lim T and Colleagues Reported A Case Of Tcm In Combinationmentioning

confidence: 76%

Cardiogenic shock due to Takotsubo cardiomyopathy following thyroidectomy

Priyankara

Manoj

Amarasena

et al. 2017

Sri Lankan J Anaesthesiol

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Takotsubo cardiomyopathy is characterized by transient left ventricular dysfunction in the absence of atherosclerotic disease. A 63yr old female with multiple autoimmune disorders was admitted to intensive care unit with severe hypotension and hypoxic respiratory failure following total thyroidectomy. During her evaluation, her 2D echocardiogram showed good basal contractions with severe mid and apical hypokinesia and an ejection fraction of 35%. Her coronary angiogram showed normal epicardial coronaries and evidence of apical ballooning suggestive of TCM. Its recognition is important for prognostic evaluation and treatment considerations. Furthermore, the relationship between autoimmunity and TCM needs to be evaluated further.

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“…TC has been linked with many thyroid disorders, the most frequent being hyperthyroidism due to Graves–Basedow disease, but there are also reports in patients with hypothyroidism, euthyroid syndrome, thyroid surgery or thyroid cancer (6, 7). …”

Section: Discussionmentioning

confidence: 99%

Takotsubo cardiomyopathy in amiodarone-induced hyperthyroidism

Capel

Tasa-Vinyals

Cano-Palomares

et al. 2017

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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SummaryTakotsubo cardiomyopathy (TC) is an atypical, severe but reversible form of acute heart insufficiency. It typically presents with left ventricular failure, transient apical and mid-segments hypokinesis, absence of significant coronary stenosis and new electrographic abnormalities and/or elevation in serum cardiac enzymes. Although TC (‘broken heart syndrome’) has classically been associated with emotional trauma, evidence suggests that other precipitants might exist, including iatrogenic and thyroid-mediated forms. Thyroid disease is a relatively common comorbidity in TC patients. We report a case of TC in a postmenopausal female with no history of emotional trauma or other potential precipitant factors who was diagnosed with amiodarone-induced hyperthyroidism during her hospital stay. Though some case reports of thyroid-related TC exist, we are not aware of any other reported case of TC precipitated by amiodarone-induced hyperthyroidism.Learning points:TC is a relatively new, rare, transient, severe, but reversible cardiovascular condition that is characterized by an acute left ventricular cardiac failure, which can clinically, analytically and electrocardiographically mimic an acute myocardial infarction.Many precipitant factors have been described in TC, being the most classical and emotional trauma. However, thyroid dysfunction is also a significant condition frequently found in patients with TC.A hypercatecholaminergic state leading to cardiomyocyte damage has been established as the main fact of TC physiopathology. Hyperthyroidism induces an upregulation of β-adrenergic receptors.Both hyperthyroidism and hypothyroidism have been related with TC development. Most reported cases of TC involving thyroid dysfunction correspond to hyperthyroidism due to Graves–Basedow disease, but there are also descriptions with severe hypothyroidism, radioiodine treatment or thyroid surgery.Amiodarone is a class III antiarrhythmic agent widely used, and it is a well-known cause of thyroid dysfunction, which can present either with hypothyroidism or hyperthyroidism, as approximately 40 percent of the amiodarone molecule is composed of iodine.In this case, a type II amiodarone-induced hyperthyroidism was the precipitant factor of a TC in a patient with a pre-existing atrial fibrillation. Given the high prevalence of atrial fibrillation and the wide use of amiodarone, the risk of this iatrogenic effect should be taken into account.

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The relationship of thyroid hormone status with myocardial function in stress cardiomyopathy

Cited by 20 publications

References 57 publications

Stress-Induced Cardiomyopathy

Stress-Induced Cardiomyopathy

Cardiogenic shock due to Takotsubo cardiomyopathy following thyroidectomy

Takotsubo cardiomyopathy in amiodarone-induced hyperthyroidism

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