Thyroid and Cardiovascular Disease: A Focused Review on the Impact of Hyperthyroidism in Heart Failure

Abstract

The association between thyroid hormones and cardiovascular conditions has been well studied, specifically, the effects of hypothyroidism on cardiomyopathy, and hyperthyroidism with arrhythmias. Nonetheless, an explicit correlation between hyperthyroidism and cardiomyopathy has yet to be established. Medical databases MEDLINE and PubMed were accessed and queried as primary sources for data acquisition. Search criteria consisted of "hyperthyroidism", "heart failure", and "thyroid and cardiovascular system", which allowed the retrieval of relevant and recent works. From these sources, a consensus was developed and employed to yield an updated review of the etiology of heart failure in the setting of hyperthyroidism. It is rare for patients with hyperthyroidism to remain in a chronic hyperthyroid state, making it difficult to analyze subsequent long-term effects on the cardiovascular system. Related to heart failure, some studies have demonstrated no change in ejection fraction, while others have shown an acute change along with diastolic dysfunction, with or without an underlying rhythm abnormality. Further investigation is warranted to elucidate the mechanism driving such cardiac dysfunction, and whether it is due to vascular changes, tachyarrhythmias, or myocyte remodeling and fibrosis. The intent of this review article is to improve our understanding of how a hyperthyroid state affects cardiovascular function. An enhanced understanding of the effects on cardiovascular physiology will afford physicians the ability to provide more comprehensive care in consideration of both endocrine and cardiovascular pathologies.

UV-B Filter Octylmethoxycinnamate Alters the Vascular Contractility Patterns in Pregnant Women with Hypothyroidism

“…Several authors have observed an association between the CV system and the thyroid diseases, but few studies have assessed the correlation between hypothyroidism and cardiac pathologies, with the exception of atrial fibrillation and tachyarrhythmias [ 55 , 56 , 57 , 58 ]. The SMC, as modulators of vascular tone, are a fundamental target for the action of TH [ 59 ].…”

“…According to these authors, Carrillo-Sepulveda, et al also demonstrated that T 3 causes nitric oxide (NO)-dependent rapid relaxation of vascular SMC by activation of PI3K/Akt-mediated endothelial nitric oxide synthase signaling pathway [ 67 ]. Consequently, recent epidemiological studies have shown that patients with hypothyroidism or with subclinical hypothyroidism may develop increased diastolic blood pressure, probably via decreased endothelium-mediated relaxation and vascular compliance [ 55 , 62 , 68 ]. In this sense, some studies suggested that this vasodilation is a result of the T 3 effects on the PI3K/Akt pathway mediated by non-genomic and genomic actions [ 69 , 70 ].…”

Hypothyroidism and Complicated Sick Sinus Syndrome and Acute Severe Psychiatric Disorder: A Case Report

“…Thyroid hormones, especially the bioactive component T3, are closely related to cardiovascular diseases and are essential for cardiovascular diseases, which affect various functions of the heart, including cardiac contractility and electrophysiological remodeling. 1 The mechanisms of T3 5 Hypothyroidism is known to be related with several ECG abnormalities including sinus bradycardia, prolonged QT interval, low voltage, prolonged the action potential duration of cardiomyocytes and heart block at varying degrees. 2 Cardiac K+ and L-type Ca++ channels in patients with hypothyroidism are affected by serum T3 and as a result, ventricular repolarization anomalies develop, which is one of the reasons why hypothyroidism patients have been reported to have an increased risk of ventricular arrhythmias.…”

“…Thyroid hormones, especially the bioactive component T3, are closely related to cardiovascular diseases and are essential for cardiovascular diseases, which affect various functions of the heart, including cardiac contractility and electrophysiological remodeling. 1 The mechanisms of T3 on cardiovascular system are diverse, mainly including the following integral aspects: 1. Binding to nuclear T3 receptors that affect the regulation of structure, contraction and gene expression; 2.…”

“…Thyroxine is closely related to cardiovascular diseases, and in some cases it is recommended that patients with heart diseases should be routinely tested for thyroid function. 1 As we all know, cardiovascular complications of severe hypothyroidism include coronary heart disease, ventricular arrhythmia, atrioventricular block, myocardial systolic weakness, pericardial effusion, low cardiac output and hypertension. 2 Rarely, hypothyroidism can cause severe sick sinus syndrome requiring pacemaker treatment.…”