The role of thyroid hormone in the pathophysiology of heart failure: clinical evidence

Galli, Elena; Pingitore, Alessandro; Iervasi, Giorgio

doi:10.1007/s10741-008-9126-6

Cited by 121 publications

(98 citation statements)

References 155 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Thyroid function abnormalities may predict poor prognosis as high BNP levels (39)(40)(41). Previously, we have shown that decreased fT3/fT4 ratio might predict worse outcome in patients with dilated cardiomyopathy (41).…”

Section: Discussionmentioning

confidence: 99%

Clinical effects of enhanced external counterpulsation treatment in patients with ischemic heart failure

Kozdağ¹,

Ertaş²,

Aygün³

et al. 2012

Anadolu Kardiyol Derg

View full text Add to dashboard Cite

Objective: Enhanced external counterpulsation (EECP) is a noninvasive treatment that is proven safe and effective in patients with coronary artery disease (CAD) and heart failure (HF). The aims of this study are to investigate the clinical effects of EECP therapy in patients with symptomatic CAD and chronic HF, and to find out an answer to the question: Does EECP therapy have any effect on the prognostic markers of HF? Methods: This study was designed as a prospective cohort study. A total of 68 consecutive patients with symptomatic CAD and chronic HF referred to EECP therapy were enrolled in this study between November 2007 and December 2010; 47 patients (39 males and 8 females, 65±7, years), have undergone EECP treatment, and 21 patients (20 males and 1 female, 62±10 years), who did not want to participate in the EECP program comprised the control group. Statistical analysis was performed using t tests for dependent and independent samples, Mann-Whitney U test, Chi-square and Fischer exact tests. Results: EECP therapy resulted in significant improvement in post-intervention New York Heart Association functional class (p<0.001), left ventricular ejection fraction (p<0.001), B-type natriuretic peptide levels (p<0.003), uric acid levels (p<0.05), free-T3/free-T4 ratio (p<0.034) and mitral annular E (p<0.05) velocity, compared with baseline, a finding not evident in the control group. Conclusion: EECP treatment significantly improved clinical and some biochemical parameters, which are mostly prognostic markers in patients with symptomatic CAD and chronic HF. (Anadolu Kardiyol Derg 2012; 12: 214-21)

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical effects of enhanced external counterpulsation treatment in patients with ischemic heart failure

Kozdağ¹,

Ertaş²,

Aygün³

et al. 2012

Anadolu Kardiyol Derg

View full text Add to dashboard Cite

show abstract

“…Despite progress in treating HF in the last 15 years, the prognosis of this dysfunction remains poor (6). In recent years, untreated overt hyperthyroidism and hypothyroidism have been reported to be common causes of HF (7,8,9,10). Moreover, persistent subclinical thyroid dysfunction has recently been associated with the development of HF in patients with and without underlying heart disease (11,12,13).…”

Section: Introductionmentioning

confidence: 99%

MECHANISMS IN ENDOCRINOLOGY: Heart failure and thyroid dysfunction

Biondi

2012

European Journal of Endocrinology

245

187

View full text Add to dashboard Cite

Context: Heart failure (HF) is a major cause of morbidity and mortality in Europe and in the United States. The aim of this review article was to assess the results of the prospective studies that evaluated the risk of HF in patients with overt and subclinical thyroid disease and discuss the mechanism of this dysfunction. Evidence Acquisition: Reports published with the following search terms were searched:, thyroid, hypothyroidism, hyperthyroidism, subclinical hyperthyroidism, subclinical hypothyroidism, levothyroxine, triiodothyronine, antithyroid drugs, radioiodine, deiodinases, clinical symptoms, heart rate, HF, systolic function, diastolic function, systemic vascular resistance, endothelial function, amiodarone and atrial fibrillation. The investigation was restricted to reports published in English. Evidence Synthesis: The outcome of this analysis suggests that patients with untreated overt thyroid dysfunction are at increased risk of HF. Moreover, persistent subclinical thyroid dysfunction is associated with the development of HF in patients with serum TSH !0.1 or O10 mU/l. Conclusions: The timely recognition and effective treatment of cardiac symptoms in patients with thyroid dysfunction is mandatory because the prognosis of HF may be improved with the appropriate treatment of thyroid dysfunction.

show abstract

“…1 Therefore, the low T3 syndrome has been established as a strong predictor of death in the cardiac, non-surgical patients. 3,7 Since cardiac surgery may bring about important alterations of the thyroid function, the postoperative low T3 syndrome has been the object of intense research during the last twenty years. The results of this study demonstrate that the presence of the low T3 syndrome at hospital admission is associated with a markedly increased risk of postoperative myocardial dysfunction and death in patients undergoing CABG surgery.…”

Section: Discussionmentioning

confidence: 99%

“…T3 administration has been shown to prevent myocardial fibrosis in aortic banded animals, and to regulate the collagen type I biosynthesis. 7 Finally, thyroid hormone deficiency is known to be associated with important alterations of the coronary blood flow due to a rarefaction in the myocardial arterioles, and with ischemic myocite loss. 7 In light of these experimental evidences, the hypothesis that the increased incidence of postoperative low cardiac output and death that we observed in patients with low T3 is at least in part due to molecular and structural alterations of the myocardium, related to the reduced fT3 availability, seems extremely likely.…”

Section: Discussionmentioning

confidence: 99%

Preoperative evaluation of basal free triiodothyronine in patients undergoing coronary artery bypass grafting surgery. Does it help?

Tiwari

Cerillo

Storti

et al. 2015

J Coll Med Sci-Nepal

View full text Add to dashboard Cite

noBackground & Objectives: The postoperative Low T3 syndrome has been considered as a possible source of reduced myocardial contractility, resulting in increased mortality after CABG. Effect of preoperative Low T3 has not been well studied in patients undergoing CABG surgery. Aim of our study is to evaluate effect of preoperative Low T3 syndrome in patients undergoing CABG surgery.Materials & Methods: Six hundred and six patients undergoing CABG were included in this prospective study. The impact of the base-line FT3 concentration and of preoperative low T3 syndrome on the risk of postoperative low cardiac output and hospital death was analyzed.Results: Fifteen patients (2.3%) postoperatively and 159 (26.2%) developed major complications. At univariate analysis a reduced EF, the presence of peripheral vascular disease, the NYHA class, the surgical urgency, the aortic cross-clamp time, the CPB time and the FT3 concentration at admission were significantly associated with low CO and higher mortality. At multivariate analysis, the CPB time, an emergency procedure, a reduced LVEF, and the fT3 concentration were independently related to the development of low CO. However, in multivariate analysis low EF, and the fT3 concentration were the only predictors of hospital death.Conclusion: We conclude that preoperative low EF and low T3 syndrome independently causes low cardiac output and higher mortality in patients undergoing CABG. Therefore, all patients undergoing CABG should be evaluated for low T3 syndrome and patients with low T3 syndrome should be considered at increased risk. Appropriate preoperative T3 replacement therapy could decrease the postoperative complications in patients undergoing CABG.JCMS Nepal. 2015; 11(2):1-7

show abstract

The role of thyroid hormone in the pathophysiology of heart failure: clinical evidence

Cited by 121 publications

References 155 publications

Clinical effects of enhanced external counterpulsation treatment in patients with ischemic heart failure

Clinical effects of enhanced external counterpulsation treatment in patients with ischemic heart failure

MECHANISMS IN ENDOCRINOLOGY: Heart failure and thyroid dysfunction

Preoperative evaluation of basal free triiodothyronine in patients undergoing coronary artery bypass grafting surgery. Does it help?

Contact Info

Product

Resources

About