Thyroid Disease and the Heart

Abstract

Abstract-The cardiovascular signs and symptoms of thyroid disease are some of the most profound and clinically relevant findings that accompany both hyperthyroidism and hypothyroidism. On the basis of the understanding of the cellular mechanisms of thyroid hormone action on the heart and cardiovascular system, it is possible to explain the changes in cardiac output, cardiac contractility, blood pressure, vascular resistance, and rhythm disturbances that result from thyroid dysfunction. The importance of the recognition of the effects of thyroid disease on the heart also derives from the observation that restoration of normal thyroid function most often reverses the abnormal cardiovascular hemodynamics. In the present review, we discuss the appropriate thyroid function tests to establish a suspected diagnosis as well as the treatment modalities necessary to restore patients to a euthyroid state. We also review the alterations in thyroid hormone metabolism that accompany chronic congestive heart failure and the approach to the management of patients with amiodarone-induced alterations in thyroid function tests.

TRH Neurons and Thyroid Hormone Coordinate the Hypothalamic Response to Cold

“…Thus, hyperthyroid patients often display enhanced cardiac contractility, while hypothyroidism may induce reduced cardiac output and bradycardia [for review, see 69]. However, more recent studies on TH control of cardiovascular function revealed an additional central mechanism originating in the hypothalamus.…”

Left ventricular end‐diastolic strain rate recovered in hypothyroidism following levothyroxine replacement therapy: A strain rate imaging study

“…Hypothyroidism has been considered a cause of diastolic and systolic heart failure . LV diastolic function plays an important role in symptom development and poor prognosis in various cardiac diseases .…”

“…But the results were derived from apical 4‐ and 2 chamber views using tissue Doppler technique, which is inherent to angle‐dependence. The reason for the decreased SRa in hypothyroidism may be associated with increased microvascular permeability, exudation of serum albumin, and decreased lymphatic clearance function, which lead to alterations of extracellular matrix, myocardial fiber orientation, and increased tissue stiffness Normalization of LV SRa with replacement therapy may indicate the improvement of these pathological changes in hypothyroidic LV. STE‐derived diastolic SR includes longitudinal, circumferential, and radial SR spatially, and isovolumic relaxation time, early and late diastolic period SR temporally .…”

“…Overt hypothyroidism is a systemic endocrine deficiency disease and has been identified as a novel risk factor for cardiovascular diseases . Hypothyroidism‐induced left ventricular (LV) systolic dysfunction has been well recognized and considered as a reversible process, but its impact on LV diastolic function has not been fully assessed.…”

Персоніфікований Підхід До Періопераційного Анестезіологічного Менеджменту Тиреоїдектомій У Пацієнтів Із Синдромом Тиреотоксикозу

“…Thyrotoxicosis is accompanied by resistance arterioles dilation and blood circulation decentralization. It has been proved by I. Klein and S. Danzi [3] that hyperthyroidism negatively affects cardiovascular haemodynamics and results in heart failure with high cardiac output, and, at late stages, in dilated cardiomyopathy. The work of P.M. Osu na et al [4] shows that early and effective hyperthyroi dism treatment can prevent congestive heart failure; the atrial fibrillation management and prevention of thromboembolic events are essential aspects of hyperthyroidism treatment.…”