Associations of Thyroid Hormones and Resting Heart Rate in Patients Referred to Coronary Angiography

2020 ◽  
Vol 52 (12) ◽  
pp. 850-855
Author(s):  
Eva Steinberger ◽  
Stefan Pilz ◽  
Christian Trummer ◽  
Verena Theiler-Schwetz ◽  
Markus Reichhartinger ◽  
...  
Keyword(s):  
Heart Rate ◽  
Coronary Angiography ◽  
Thyroid Hormones ◽  
Thyroid Stimulating Hormone ◽  
Resting Heart Rate ◽  
Free Triiodothyronine ◽  
Free Thyroid Hormones ◽  
Cardiovascular Morbidity And Mortality ◽  
Increased Risk ◽  
Significant Difference

AbstractResting heart rate (RHR) is associated with increased risk of cardiovascular morbidity and mortality. Thyroid hormones exert several effects on the cardiovascular system, but the relation between thyroid function and RHR remains to be further established. We evaluated whether measures of thyroid hormone status are associated with RHR in patients referred to coronary angiography. Thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxin (FT4), and RHR were determined in 2795 participants of the Ludwigshafen Risk and Cardiovascular Health (LURIC) Study. Median (25th to 75th percentile) serum concentrations were 1.25 (0.76–1.92) mU/l for TSH, 4.8 (4.2–5.3) pmol/l for FT3 and 17.1 (15.4-19.0) pmol/l for FT4, and mean (±standard deviation) RHR was 68.8 (±11.7) beats/min. Comparing the highest versus the lowest quartile, RHR (beats/min) was significantly higher in the fourth FT4 quartile [3.48, 95% confidence interval (CI): 2.23–4.73; p <0.001] and in the fourth FT3 quartile (2.30, 95% CI: 1.06–3.55; p <0.001), but there was no significant difference for TSH quartiles. In multiple linear regression analyses adjusting for various potential confounders, FT3 and FT4 were significant predictors of RHR (p <0.001 for both). In subgroups restricted to TSH, FT3, and FT4 values within the reference range, both FT3 and FT4 remained significant predictors of RHR (p <0.001 for all). In conclusion, in patients referred to coronary angiography, FT3 and FT4 but not TSH were positively associated with RHR. The relationship between free thyroid hormones and RHR warrants further investigations regarding its diagnostic and therapeutic implications.

scholarly journals Correlations of Free Thyroid Hormones Measured by Tandem Mass Spectrometry and Immunoassay with Thyroid-Stimulating Hormone across 4 Patient Populations

2009 ◽  
Vol 55 (7) ◽  
pp. 1380-1388 ◽  
Author(s):  
Jacqueline Jonklaas ◽  
Natasa Kahric-Janicic ◽  
Offie P Soldin ◽  
Steven J Soldin
Keyword(s):  
Mass Spectrometry ◽  
Thyroid Hormone ◽  
Tandem Mass Spectrometry ◽  
Thyroid Hormones ◽  
Thyroid Stimulating Hormone ◽  
Free Thyroxine ◽  
Tandem Mass ◽  
Free Triiodothyronine ◽  
Free Thyroid Hormones ◽  
Free Thyroid Hormone

Abstract Background: Accurate measurement of free thyroid hormones is important for managing thyroid disorders. Ultrafiltration liquid chromatography tandem mass spectrometry (LC-MS/MS) can reliably measure the concentrations of small molecules, including thyroid hormones. Our study was designed to compare free thyroid hormone measurements performed with immunoassay and LC-MS/MS. Methods: We studied the performance of LC-MS/MS in 4 different populations comprising pediatric patients, euthyroid adults, and healthy nonpregnant and pregnant women. The samples obtained from each population numbered 38, 200, 28, and 128, respectively. Free thyroxine, free triiodothyronine, and thyroid-stimulating hormone (TSH) concentrations were documented. Results: LC-MS/MS measurement of free thyroid hormones provided better correlation with log-transformed serum TSH in each population and also the populations combined. The correlations between free thyroxine measured by LC-MS/MS and log TSH in the pediatric outpatients and healthy adults were −0.90 and −0.77, respectively. The correlations for immunoassay were −0.82 and −0.48. The correlations between free triiodothyronine measured by LC-MS/MS and TSH for both pediatric and healthy adult populations were −0.72 and −0.68, respectively. Conclusions: Free thyroid hormone concentrations measured by LC-MS/MS correlate to a greater degree with log TSH values compared to concentrations measured by immunoassay. This correlation was maintained across the patient populations we studied and may reflect the accuracy and specificity of LC-MS/MS. The superior ability of LC-MS/MS to enable documentation of the well-known thyroid hormone–TSH relationship supports the use of this measurement technique in a variety of clinical situations.

Thyroid-Stimulating Hormone, Degree of Obesity, and Metabolic Risk Markers in a Cohort of Swedish Children with Obesity

2017 ◽  
Vol 88 (2) ◽  
pp. 140-146 ◽  
Author(s):  
Veroniqa Lundbäck ◽  
Kerstin Ekbom ◽  
Emilia Hagman ◽  
Ingrid Dahlman ◽  
Claude Marcus
Keyword(s):  
Glucose Metabolism ◽  
Thyroid Hormones ◽  
Positive Association ◽  
Thyroid Stimulating Hormone ◽  
Metabolic Risk ◽  
Model Assessment ◽  
Free Triiodothyronine ◽  
Free Thyroid Hormones ◽  
Tsh Levels ◽  
Stimulating Hormone

Background/Aims: Thyroid-stimulating hormone (TSH) is affected in obesity and might influence metabolic risk. It is unclear what mechanisms cause elevated TSH in obesity. We aimed to investigate TSH status within the normal range and the association of TSH with degree of obesity and metabolic parameters in children with obesity. Methods: A total of 3,459 children, aged 3.0–17.9 years, were identified in the Swedish Childhood Obesity Treatment Registry, BORIS. Age, gender, TSH, free triiodothyronine (fT3), free thyroxine (fT4), body mass index standard deviation scores (BMI SDS), as well as variables of lipid and glucose metabolism were examined. Results: Children with high-normal TSH (>3.0 mU/L) (28.8%) had higher BMI SDS compared to children with low-normal TSH (<3.0 mU/L) (p < 0.001). Multivariable regression analysis adjusted for age and gender showed that TSH levels were associated with BMI SDS (β: 0.21, 95% CI: 0.14–0.28, p < 0.001). Associations of thyroid hormones with markers of lipid and glucose metabolism were observed, where TSH was associated with fasting insulin, HOMA (homeostatic model assessment of insulin resistance), total cholesterol, and triglycerides. Conclusions: A positive association between TSH levels and BMI SDS was seen in children with obesity. Associations of TSH and free thyroid hormones with glucose metabolism indicated that TSH might be one of several factors acting to determine body weight and obesity co-morbidities, although the underlying mechanism remains unclear.

P5513Relation of thyroid hormones level to the extent of myocardial injury in patients with acute coronary syndrome

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Badran ◽  
G Soltan ◽  
A Belal
Keyword(s):  
Acute Coronary Syndrome ◽  
Thyroid Hormones ◽  
Myocardial Injury ◽  
Troponin I ◽  
Thyroid Stimulating Hormone ◽  
Gensini Score ◽  
Thyroid Status ◽  
Free Triiodothyronine ◽  
Coronary Syndrome ◽  
Significant Difference

Abstract Objective Previous studies have identified that abnormal thyroid hormonal status is associated with worse prognosis especially in coronary artery disease (CAD). The present study further explores whether thyroid hormones associated with size of myocardial injury and extent of CAD in patients with acute coronary syndrome (ACS). Methods In this study, we enrolled 120 consecutive patients (52% male, mean age 54.2±6.4 years) who were admitted to ICU with ACS and having coronary angiography. All patients underwent testing for thyroid function status [thyroid stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4)], cardiac troponin I (cTnI), cardiac enzymes, C-reactive protein (CRP). Risk profile, clinical characteristics and angiographic results (Gensini score) were also analyzed. Results 43.3% of patients presented with STEMI, 33.3% with NSTEMI and 23.3% unstable angina. CK-MB, troponin and CRP were significantly higher in STEMI compared with NSTEMI group (P<0.0001). Abnormal thyroid status was prevalent in 13.4% of total population; Low FT3 syndrome in 6.7%, subclinical hypothyroidism in 5% and clinical hypothyroidism in 1.7%. Lower thyroid hormone levels showed significantly lower HDL (P<0.02), higher triglyceride level& CRP and cTnI (P<0.007), higher rate of in hospital complications including recurrent angina, CHF and cardiogenic shock (P<0.001) and more severe CAD using Gensini score (P<0.0001). However, there was no significant difference in abnormal thyroid status between STEMI and NSTEMI. After adjusting for conventional risk factors, FT3 showed direct correlation to LV EF% (r=0.62, P<0.000) and inverse correlation to LV internal dimension (r=−0.57, P<0.0001), troponin (r=−0.27, P<0.03), CRP (r=−0.39, P<0.003), Gensini score (r=−0.48, P<0.0001) and number of in hospital complications (r=−0.62, P<0.0001). From a linear stepwise regression analysis low EF% (β: 0.032, 95% CI: 0.009–0.055, P<0.007) and presence of complications (β: 0.625, 95% CI: 1.194–0.056, P<0.03) are independent predictors of low FT3. Conclusions In ACS, the lower thyroid hormones levels are associated with larger myocardial injury, more severe CAD and higher rate of complications especially during their hospital course.

Correction: Associations of Thyroid Hormones and Resting Heart Rate in Patients Referred to Coronary Angiography

2020 ◽  
Author(s):  
Eva Steinberger ◽  
Stefan Pilz ◽  
Christian Trummer ◽  
Verena Theiler-Schwetz ◽  
Markus Reichhartinger ◽  
...  
Keyword(s):  
Heart Rate ◽  
Coronary Angiography ◽  
Thyroid Hormones ◽  
Resting Heart Rate

scholarly journals RESTING HEART RATE MODERATES THE RELATIONSHIP BETWEEN NEUROPSYCHIATRIC SYMPTOMS, MCI, AND ALZHEIMER’S DISEASE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S641-S641
Author(s):  
Shanna L Burke
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Heart Rate ◽  
Relative Risk ◽  
Neuropsychiatric Symptoms ◽  
Cognitive Status ◽  
Resting Heart Rate ◽  
Data Set ◽  
Increased Risk ◽  
The Relationship

Abstract Little is known about how resting heart rate moderates the relationship between neuropsychiatric symptoms and cognitive status. This study examined the relative risk of NPS on increasingly severe cognitive statuses and examined the extent to which resting heart rate moderates this relationship. A secondary analysis of the National Alzheimer’s Coordinating Center Uniform Data Set was undertaken, using observations from participants with normal cognition at baseline (13,470). The relative risk of diagnosis with a more severe cognitive status at a future visit was examined using log-binomial regression for each neuropsychiatric symptom. The moderating effect of resting heart rate among those who are later diagnosed with mild cognitive impairment (MCI) or Alzheimer’s disease (AD) was assessed. Delusions, hallucinations, agitation, depression, anxiety, elation, apathy, disinhibition, irritability, motor disturbance, nighttime behaviors, and appetite disturbance were all significantly associated (p&lt;.001) with an increased risk of AD, and a reduced risk of MCI. Resting heart rate increased the risk of AD but reduced the relative risk of MCI. Depression significantly interacted with resting heart rate to increase the relative risk of MCI (RR: 1.07 (95% CI: 1.00-1.01), p&lt;.001), but not AD. Neuropsychiatric symptoms increase the relative risk of AD but not MCI, which may mean that the deleterious effect of NPS is delayed until later and more severe stages of the disease course. Resting heart rate increases the relative risk of MCI among those with depression. Practitioners considering early intervention in neuropsychiatric symptomology may consider the downstream benefits of treatment considering the long-term effects of NPS.

Abstract 187: Electrocardiographic Heart Rate-corrected Qt Interval And Risk Of Stroke In The REasons For Geographic And Racial Differences In Stroke (REGARDS) Study

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Elsayed Z Soliman ◽  
George Howard ◽  
George Howard ◽  
Mary Cushman ◽  
Brett Kissela ◽  
...  
Keyword(s):  
Heart Rate ◽  
Racial Differences ◽  
Qt Interval ◽  
Proportional Hazards ◽  
Left Ventricular ◽  
Cox Proportional Hazards ◽  
Corrected Qt Interval ◽  
Cardiovascular Morbidity And Mortality ◽  
Increased Risk ◽  
Regards Study

Background: Prolongation of heart rate-corrected QT interval (QTc) is a well established predictor of cardiovascular morbidity and mortality. Little is known, however, about the relationship between this simple electrocardiographic (ECG) marker and risk of stroke. Methods: A total of 27,411 participants aged > 45 years without prior stroke from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study were included in this analysis. QTc was calculated using Framingham formula (QTcFram). Stroke cases were identified and adjudicated during an up to 7 years of follow-up (median 2.7 years). Cox proportional hazards analysis was used to estimate the hazard ratios for incident stroke associated with prolonged QTcFram interval (vs. normal) and per 1 standard deviation (SD) increase, separately, in a series of incremental models. Results: The risk of incident stroke in the study participants with baseline prolonged QTcFram was almost 3 times the risk in those with normal QTcFram [HR (95% CI): 2.88 (2.12, 3.92), p<0.0001]. After adjustment for age, race, sex, antihypertensive medication use, systolic blood pressure, current smoking, diabetes, left ventricular hypertrophy, atrial fibrillation, prior cardiovascular disease, QRS duration, warfarin use, and QT-prolonging drugs (full model), the risk of stroke remained significantly high [HR (95% CI): 1.67 (1.16, 2.41), p=0.0060)], and was consistent across several subgroups of REGARDS participants. When the risk of stroke was estimated per 1 SD increase in QTcFram, a 24% increased risk was observed [HR (95% CI): 1.24 (1.16, 1.33), p<0.0001)]. This risk remained significant in the fully adjusted model [HR (95% CI): 1.12 (1.03, 1.21), p=0.0055]. Similar results were obtained when other QTc correction formulas including Hodge’s, Bazett’s and Fridericia’s were used. Conclusions: QTc prolongation is associated with a significantly increased risk of incident stroke independently from known stroke risk factors. In light of our results, examining the risk of stroke associated with QT-prolonging drugs may be warranted.

Effect of smoking on cardiovascular autonomic functions

2021 ◽  
Vol 9 (2) ◽  
pp. 3780-3784
Author(s):  
P.Vani ◽  
◽  
Sharan B Singh M ◽  
Keyword(s):  
Heart Rate ◽  
Autonomic Function ◽  
T Test ◽  
Resting Heart Rate ◽  
Autonomic Functions ◽  
Mean Values ◽  
Function Tests ◽  
Significant Difference ◽  
The Mean ◽  
The Difference

Introduction: Cigarette smoking is a prime risk factor for cardiovascular morbidity and mortality. Chronic smoking results in autonomic dysfunction leading to increased cardiovascular risk in smokers. The present study was planned to study the effect of smoking on the Cardiovascular Autonomic Functions among smokers. Materials and Methods: Fifty male subjects who were in the age group of 25 to 45 years. They were grouped into 25 smokers and 25 non-smokers. The participant subjects were selected among the staff members, residents and the patients from the routine OPD in SVIMS. Prior to study, they were informed about the procedure and the purpose of the study tests and written consents were obtained from them. The Cardiovascular Autonomic Function Tests were assessed by using a POLYGRAPH which was available in the department. Results and Conclusion: After applying the ‘t’-test for the difference between the two sample means, it was observed that there was a highly significant difference between the mean values of the BMI(i.e.p<0.01) and the para-sympathetic function tests among the smokers and the non – smokers(i.e.p<0.00). The Resting Heart Rate had significantly increased and the Deep breathing difference, the postural tachycardial index (Response to standing) and the Valsalva Ratio had significantly decreased in the smokers as compared to those in the non – smokers. After applying the ‘t’-test for the difference between the two sample means, it was observed that there was no significant difference between the mean values of the Postural hypotension test (i.e. p>0.05) and that there was a highly significant difference between the mean values of the Sustained handgrip test in the smokers and the non – smokers (i.e. p<0.00). KEY WORDS: Cardiovascular autonomic function tests, Smoking, Resting heart rate.

scholarly journals Reference Intervals of Thyroid Hormones and Correlation of BMI with Thyroid Function in Healthy Zhuang Ethnic Pregnant Women

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Yonghong Sheng ◽  
Dongping Huang ◽  
Shun Liu ◽  
Xuefeng Guo ◽  
Jiehua Chen ◽  
...  
Keyword(s):  
Thyroid Hormones ◽  
Pregnant Women ◽  
Thyroid Function ◽  
Reference Intervals ◽  
Thyroid Stimulating Hormone ◽  
Specific Reference ◽  
American Thyroid Association ◽  
Reference Ranges ◽  
Free Triiodothyronine ◽  
Cross Sectional

Ethnic differences in the level of thyroid hormones exist among individuals. The American Thyroid Association (ATA) recommends that an institution or region should establish a specific thyroid hormone reference value for each stage of pregnancy. To date, a limited number of studies have reported the level of thyroid hormones in Chinese minorities, and the exact relationship between BMI and thyroid function in pregnant women is ill. This study was performed to establish trimester-specific reference ranges of thyroid hormones in Zhuang ethnic pregnant women and explore the role of body mass index (BMI) on thyroid function. A total of 3324 Zhuang ethnic health pregnant women were recruited in this Zhuang population-based retrospective cross-sectional study. The values of thyroid stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) were determined by automatic chemiluminescence immunoassay analyzer. Multivariate linear regression and binary logistic regression were constructed to evaluate the influence of BMI on the thyroid function. The established reference intervals for the serum thyroid hormones in three trimesters were as follows: TSH, 0.02–3.28, 0.03–3.22, and 0.08-3.71 mIU/L; FT4, 10.57–19.76, 10.05–19.23, and 8.96–17.75 pmol/L; FT3, 3.51–5.64, 3.42–5.42, and 2.93–5.03 pmol/L. These values were markedly lower than those provided by the manufacturers for nonpregnant adults which can potentially result in 6.10% to 19.73% misclassification in Zhuang pregnant women. Moreover, BMI was positively correlated with isolated hypothyroxinemia (OR=1.081, 95% CI=1.007–1.161), while the correlation between the BMI and subclinical hypothyroidism was not statistically significant (OR=0.991, 95% CI=0.917–1.072). This is the first study focusing on the reference ranges of thyroid hormones in Guangxi Zhuang ethnic pregnant women, which will improve the care of them in the diagnosis and treatment. We also found that high BMI was positively associated with the risk of isolated hypothyroxinemia.

Abstract 529: Muscle Sympathetic Nerve Activity is Higher in Winter than Other Seasons

Hypertension ◽  
2013 ◽  
Vol 62 (suppl_1) ◽  
Author(s):  
Jian Cui ◽  
Matthew D Muller ◽  
Allen R Kunselman ◽  
Cheryl Blaha ◽  
Lawrence I Sinoway
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Sympathetic Nerve ◽  
Sympathetic Nerve Activity ◽  
Muscle Sympathetic Nerve Activity ◽  
Epidemiological Data ◽  
Repeated Measurements ◽  
Nerve Activity ◽  
Cardiovascular Morbidity And Mortality ◽  
Significant Difference

Epidemiological data suggest that blood pressure tends to be higher in winter and lower in summer, particularly in the elderly. Moreover, hospitalization and mortality rates due to cardiovascular disease have higher rates in winter than summer. Whether autonomic adjustment including muscle sympathetic nerve activity (MSNA) varies with season is unclear. To test the hypothesis that resting MSNA varies along the seasons, we retrospectively analyzed the supine baseline (6 min) MSNA and heart rate (from ECG) of 57 healthy subjects (33M, 24F, 29 ± 1 yrs, range 22-64 yrs) from studies in our laboratory (room temperature ~23 °C). Each of these subjects from central Pennsylvania was studied during 2 or more seasons (total 231 visits). A linear-mixed effects model, which is an extension of the analysis of variance model accounting for repeated measurements (i.e. season) per subject, was used to assess the association of season with the cardiovascular outcomes. The Tukey-Kramer procedure was used to account for multiple comparisons testing between the seasons. MSNA burst rate in winter (21.3 ± 1.0 burst/min) was significantly greater than in summer (13.7 ± 1.0 burst/min, P < 0.001), spring (17.5 ± 1.6 burst/min, P = 0.04) and fall (17.0 ± 1.2 burst/min, P < 0.002). There was no significant difference in MSNA in other comparisons (spring vs. summer, P = 0.12; spring vs. fall, P = 0.99; summer vs. fall, P = 0.054). Heart rate (63.6 ± 1.1 vs. 60.8 ± 1.2 beats/min, P = 0.048) was significantly greater in winter compared to summer. Blood pressure (automated sphygmomanometry of the brachial artery) was not significantly different between seasons. The results suggest that baseline sympathetic nerve activity varies along the seasons, with peak levels evident in winter. We speculate that the seasonal MSNA variation may contribute to seasonal variations in cardiovascular morbidity and mortality.

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