Thyroid Replacement Therapy and Heart Failure

Gerdes, A. Martin; Iervasi, Giorgio

doi:10.1161/circulationaha.109.917922

Cited by 187 publications

(168 citation statements)

References 105 publications

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“…The transition from the foetal to the adult phenotype heart depends on the increase in thyroid hormone in the perinatal stage (7). Moreover, normal thyroid hormone levels are required in adult life to maintain normal cardiovascular function (7,17,18,19).…”

Section: Cardiovascular Function In Hypothyroidismmentioning

confidence: 99%

“…Moreover, normal thyroid hormone levels are required in adult life to maintain normal cardiovascular function (7,17,18,19). T 3 controls the inotropic and lusitropic properties of the myocardium, cardiac growth, myocardial contractility and vascular function (14,15).…”

Section: Cardiovascular Function In Hypothyroidismmentioning

confidence: 99%

“…Experimental studies have demonstrated that hypothyroidism causes cardiac atrophy due to decreased aMHC expression and increased bMHC expression. Moreover, hypothyroidism leads to chamber dilatation and impaired myocardial blood flow (7,17,18,19). In an early study, myxoedema and congestive HF were diagnosed in a patient affected by hypothyroidism (86).…”

Section: Hf and Hypothyroidismmentioning

confidence: 99%

“…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%

“…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). Thyroid dysfunction is a modifiable risk factor in patients who are at risk of HF (7,9).…”

Section: Introductionmentioning

confidence: 99%

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MECHANISMS IN ENDOCRINOLOGY: Heart failure and thyroid dysfunction

Biondi

2012

European Journal of Endocrinology

245

187

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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.

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Section: Cardiovascular Function In Hypothyroidismmentioning

confidence: 99%

Section: Cardiovascular Function In Hypothyroidismmentioning

confidence: 99%

Section: Hf and Hypothyroidismmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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MECHANISMS IN ENDOCRINOLOGY: Heart failure and thyroid dysfunction

Biondi

2012

European Journal of Endocrinology

245

187

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Association Between Iodinated Contrast Media Exposure and Incident Hyperthyroidism and Hypothyroidism

Rhee

Bhan²,

Alexander³

et al. 2012

Arch Intern Med

187

145

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Thyroid Hormone and Cardioprotection

Gerdes

Ojamaa

2016

Comprehensive Physiology

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The heart is a major target of thyroid hormones, with maintenance of euthyroid hormone balance critical for proper function. In particular, chronic low thyroid function can eventually lead to dilated heart failure with impaired coronary blood flow. New evidence also suggests that heart diseases trigger a reduction in cardiac tissue thyroid hormone levels, a condition that may not be detectible using serum hormone assays. Many animal and clinical studies have demonstrated a high prevalence of low thyroid function in heart diseases with worse outcomes from this condition. Animal and human studies have also demonstrated many benefits from thyroid hormone treatment of heart diseases, particularly heart failure. Nonetheless, this potential treatment has not yet translated to patients due to a number of important concerns. The most serious concern involves the potential of accidental overdose leading to increased arrhythmias and sudden death. Several important clinical studies, which actually used excessive doses of thyroid hormone analogs, have played a major role in convincing the medical community that thyroid hormones are simply too dangerous to be considered for treatment in cardiac patients. Nonetheless, this issue has not gone away due primarily to overwhelmingly positive evidence for treatment benefits and a new understanding of the cellular and molecular mechanisms underlying those benefits. This review will first discuss the clinical evidence for the use of thyroid hormones as a cardioprotective agent and then provide an overview of the cellular and molecular mechanisms underlying beneficial changes from thyroid hormone treatment of heart diseases. © 2016 American Physiological Society. Compr Physiol 6:1199-1219, 2016.

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Thyroid Replacement Therapy and Heart Failure

Cited by 187 publications

References 105 publications

MECHANISMS IN ENDOCRINOLOGY: Heart failure and thyroid dysfunction

MECHANISMS IN ENDOCRINOLOGY: Heart failure and thyroid dysfunction

Association Between Iodinated Contrast Media Exposure and Incident Hyperthyroidism and Hypothyroidism

Thyroid Hormone and Cardioprotection

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