scholarly journals Impact of Resistance to Thyroid Hormone on the Cardiovascular System in Adults

2009 ◽  
Vol 30 (5) ◽  
pp. 541-541
Author(s):  
Melania Pulcrano ◽  
Emiliano Palmieri ◽  
Deborah Mannavola ◽  
Irene Campi ◽  
Danila Covelli ◽  
...  

ABSTRACT Background The clinical manifestations of resistance to thyroid hormone (RTH) are highly variable, and the impact of RTH on the cardiovascular system has been poorly investigated. Aim The objective of the study was to evaluate the cardiovascular characteristics of 16 untreated and asymptomatic patients with RTH compared with 16 euthyroid healthy controls to define the cardiovascular involvement in RTH syndrome. Patients and Methods Sixteen untreated and asymptomatic RTH patients (eight males; aged 33 ± 12 yr, range 21–45 yr) and 16 controls (nine males; aged 33 ± 5 yr, range 24–42 yr) were enrolled. Clinical data, thyroid status, and echocardiographic results were recorded. Results Heart rate was comparable with that of controls, whereas arterial pressure was higher than controls. Mean interventricular septum diastolic thickness and mean left ventricular (LV) posterior wall diastolic thickness were significantly lower in RTH patients than controls with a consequent significant decrease of the mean LV mass and LV mass indexed by body surface area. Patients also had abnormalities of myocardial relaxation as indicated by a significant increase of peak A and consequent reduction of the early to late ratio. Finally, systemic vascular resistance was significantly higher in RTH patients than controls. Conclusions Our results suggest the presence of cardiovascular alterations in asymptomatic and untreated RTH patients similar to those reported in hypothyroid patients. Our strict selection likely created a bias in the inclusion of a particular type of RTH patients, who could represent a minority of patients with RTH. However, no correlation was found between the type of mutation and cardiovascular characteristics of RTH patients.

2009 ◽  
Vol 94 (8) ◽  
pp. 2812-2816 ◽  
Author(s):  
Melania Pulcrano ◽  
Emiliano Antonio Palmieri ◽  
Deborah Mannavola Michele Ciulla ◽  
Irene Campi ◽  
Danila Covelli ◽  
...  

Background: The clinical manifestations of resistance to thyroid hormone (RTH) are highly variable, and the impact of RTH on the cardiovascular system has been poorly investigated. Aim: The objective of the study was to evaluate the cardiovascular characteristics of 16 untreated and asymptomatic patients with RTH compared with 16 euthyroid healthy controls to define the cardiovascular involvement in RTH syndrome. Patients and Methods: Sixteen untreated and asymptomatic RTH patients (eight males; aged 33 ± 12 yr, range 21–45 yr) and 16 controls (nine males; aged 33 ± 5 yr, range 24–42 yr) were enrolled. Clinical data, thyroid status, and echocardiographic results were recorded. Results: Heart rate was comparable with that of controls, whereas arterial pressure was higher than controls. Mean interventricular septum diastolic thickness and mean left ventricular (LV) posterior wall diastolic thickness were significantly lower in RTH patients than controls with a consequent significant decrease of the mean LV mass and LV mass indexed by body surface area. Patients also had abnormalities of myocardial relaxation as indicated by a significant increase of peak A and consequent reduction of the early to late ratio. Finally, systemic vascular resistance was significantly higher in RTH patients than controls. Conclusions: Our results suggest the presence of cardiovascular alterations in asymptomatic and untreated RTH patients similar to those reported in hypothyroid patients. Our strict selection likely created a bias in the inclusion of a particular type of RTH patients, who could represent a minority of patients with RTH. However, no correlation was found between the type of mutation and cardiovascular characteristics of RTH patients.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Aldujeli ◽  
J Laukaitiene ◽  
R Unikas

Abstract Background Regular physical exercise causes a continuous gradual increase of the cardiac left ventricular (LV) mass known as physiological adaptive hypertrophy. The extent of LV remodeling depends on the type, amount, and intensity of the exercise. Purpose The aim of this study was to compare structural changes of the heart among Lithuanian football, basketball players and unathletic controls. Methods A total of 50 Lithuanian males aged between 20-29 years volunteered to participate in the study. Football players (n = 15) playing for local II league football clubs,and Basketball players (n = 15) playing for local minor league basketball teams. All athletes had been regularly engaged in their sport for at least three years. Inactive healthy volunteers (n = 20) of similar age served as controls. Routine transthoracic echocardiographic examinations to measure end-diastolic LV dimensions were performed by cardiology fellow under the supervision of a fully licensed cardiologist. Statistical analyses were performed using the SPSS 20.0 software. The value of p < 0,05 was considered as statistically significant. Results No structural or functional pathologies were evident during the echocardiographic examination in any of the subjects. Absolute interventricular septum (IVS) thickness and LV posterior wall thickness, but not LV diameter, were higher in athletes than in inactive controls (P < 0,001). Indexed LV diameter was higher in football players as compared with non-athlete controls and basketball players (P < 0,05). Left ventricular mass of all athletes were higher as compared with controls (p < 0.001). Relative wall thickness was not increased in football players but was higher in basketball players as compared with controls (p < 0.05). Conclusion Cardiac remodeling in Lithuanian football players resulted in left ventricle eccentric hypertrophy due to the LV dilation, increased LV mass and relatively normal relative wall thickness. However in Lithuanian basketball players we noticed an increase in both relative wall thickness and LV mass resulting in LV concentric hypertrophy. Echocardiographic characteristics Groups n End-diastolic LV diameter(mm) End-diastolic Interventricular septum (mm) End-diastolic LV posterior wall LV mass Football Players 15 56.9 10.8 10.8 242 Basketball players 15 53.6 11.5 11.3 254 Inactive individuals 20 53.2 9.1 9.5 182 P value 0.01 <0.001 <0.001 <0.01 Abstract P955 Figure.


2019 ◽  
Vol 6 (3) ◽  
pp. 3027-3033
Author(s):  
Lozinska Marina ◽  
Zhebel Vadym ◽  
Lozinsky Sergiy

Objectives: Hypertensive heart remodeling requires the assumption of different factors, including an increase of left ventricular mass (LVM) and myocardial fibrosis. It was shown that aldosterone stimulates cardiac collagen synthesis and fibroblast proliferation. CYP11B2 is one of the genes responsible for the effects of aldosterone. Therefore, hypertensive remodeling could be partially related to the polymorphism of this gene. The purpose of this study was to assess the association of CYP11B2 polymorphism with structural remodeling by changes in geometry and myocardial density to define their role and interaction in hypertensive heart disease. Methods: The study recruited 150 men aged 45-60 with and without essential hypertension (EH), who possessed no irreversible target organ damages. Fifty of them had normal BP, 58 had EH without left ventricular hypertrophy (LVH) and 42 had EH and LVH. Each participant underwent office blood pressure measurement, echocardiography with echo-reflectivity analysis, and determination of the C-344T polymorphism of the aldosterone synthase gene CYP11B2. Results: Patients with EH and LVH differed not only by LV mass but also by larger body mass, relative wall thickness, and wider echo-reflectivity spectrum. The associations of larger end diastolic diameter with C allele, and the larger thickness of the posterior wall and interventricular septum with T allele, were revealed only in patients with EH and LVH. Conclusions: Hypertensive patients with LVH are likely to be a distinct cluster with their own genetic predisposition to hypertensive heart disease.  


2021 ◽  
Vol 129 (Suppl_1) ◽  
Author(s):  
Buyan-Ochir Orgil ◽  
Fuyi Xu ◽  
Undral Munkhsaikhan ◽  
Neely R Alberson ◽  
Jason Johnson ◽  
...  

Background: Causal and modifier genes, genetic background and environment underlie clinical heterogeneity in cardiomyopathy (CM). The BXD recombinant inbred (RI) family represents a murine genetic reference population (GRP) that are descendants from crosses between C57BL/6J (B6) and DBA/2J (D2) mice. The parental D2 mouse is a natural model of hypertrophic CM (HCM). The study aimed to dissect genetic architecture of cardiac traits in BXD GRP using systems genetics analysis. Methods: Echocardiography was performed in 88 strains of male (M) and female (F) BXDs (N>5/sex) at 4-5 months of age. Cardiac traits were then associated with heart transcriptome, and expression quantitative trait loci ( eQTL) mapping was performed. Results: More than 2-fold variance in ejection fraction (EF%), fractional shortening (FS%), left ventricular (LV) volumes at end-systole and end-diastole (Vol;s and Vol;d), internal dimensions (ID;s and ID;d), posterior wall (PW), and interventricular septum (IVS) thickness was found among BXDs. Traits seen in dilated CM (DCM) patients such as reduced EF%, FS%, and LVPW and increased Vol;s and ID;s are found in BXD78 (M, F), BXD32, 111, and 68 (F) strains. Strains D2, BXD90 and 155 (M, F), BXD44 and 65 (M), and BXD113, 16, 77 (F) had significantly greater LV mass, LVPW and IVS thickness compared to sex-matched controls, suggestive for traits seen in HCM patients. A 6.4 Mb QTL (peak LRS=18.50) was identified on chromosome (Chr) 8 to be significantly associated with ID;s, ID;d, Vol;s and Vol;d among male BXDs. eQTL mapping for each of 131 genes on Chr8 QTL identified 6 genes ( Coq9 , Ndrg4 , Crnde, Irx3, Rpgrip1l, and Rbl2 ) being cis -regulated and Ndrg, Slc6a2 and Ces1d being significantly (p < 0.05) correlated with LV volumes. In female BXDs, a significant QTL on Chr7 (40.2 Mb) with 9 genes that significantly correlated with LVPW;d was identified. A suggestive 92.6 Mb QTL on Chr3 with Snapin , Tpm3 , and Wars2 correlated with EF% and FS% (p < 0.05). Conclusions: Our study found cardiomyopathy-associated traits are segregated among BXD family and these traits vary among BXD lines. Multiple associated QTLs demonstrate that the BXD family is suitable to map gene variants and identify genetic factors and modifiers that influence cardiomyopathy phenotypes.


2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
Y K Taha ◽  
C A Rambart ◽  
F Reifsteck ◽  
R Hamburger ◽  
J R Clugston ◽  
...  

Abstract Background There is a paucity of data describing left ventricular geometry changes in female athletes. While some studies suggest that female athletes participating in dynamic sports exhibit higher prevalence of eccentric left ventricular hypertrophy (LVH) when compared to men, a recent study suggested more concentric geometry changes in female basketball athletes. We were unable to identify studies describing the left ventricular geometry of female collegiate swimmers. Objectives To describe LV geometry changes in a cohort of female collegiate swimmers. Methods We analyzed a cohort of female collegiate swimmers who had a pre-participation cardiac evaluation by 12-lead ECG and 2-dimensional echocardiography. Left ventricular (LV) geometry was assessed based on relative wall thickness (RWT) (defined as: 2 x posterior wall thickness (PWT) divided by LV end-diastolic diameter (LVEDD)) and LV mass (LVM) (Devereux's formula: LVM = [0.8 x 1.04 [(LVEDD + interventricular septum + posterior wall thickness)3 − (LVEDD)3]] + 0.6g) and was indexed to body surface area (BSA).LVH was defined as LV mass index &gt;95 g and was defined as concentric when associated with a relative wall thickness (RWT) &gt;0.42 and as eccentric when RWT was ≤0.42. Concentric remodeling was defined as normal LVM index and increased RWT. Results A total of 83 female collegiate swimmers were included. Their age was 18.5±0.5 years (mean ± standard deviation, SD), 74 (89.2%) were White, BSA was 1.78±0.11 m2, height 173±6.3 cm, weight 66.2±7.2 K. Their interventricular septum diameter was 0.89±0.14 cm, PWT 0.92±0.15 cm, LVEDD 4.9±0.5 cm and LV end-systolic diameter (LVESD) 3.2±0.4 cm. Left atrium diameter ranged from 2.6 to 4.3 cm (mean 3.4 cm ± 0.4 cm). Aortic root diameter ranged from 1.9 to 3.5 cm (mean 2.7±0.3 cm) (Figure 1). LVH was present in 27 swimmers (32.5%). Eccentric LVH was present in 17 athletes (20.5%), concentric hypertrophy in 10 athletes (12%), and concentric remodeling in 12 (14.5%) (Figure 2). No athletes with LVH or concentric remodeling had borderline or abnormal ECG findings based on international criteria. Only two women with normal LV geometry had abnormal ECG findings: prolonged QT interval and abnormal T wave inversion. There was a linear correlation between BSA with LVEDD, LVESD and LV mass (r=0.40, 0.35, and 0.48 with P&lt;0.001,0.002 and &lt;0.001, respectively). However, there was no statistically significant difference between LV geometry groups based on BSA or blood pressure. Conclusion Our data document a high incidence of eccentric hypertrophy among female collegiate swimmers. Concentric remodeling and hypertrophy were also relatively high. Differentiating physiologic from pathologic cardiac remodeling in these athletes is critical to prevent potential complications such as sudden cardiac death, arrhythmias, and other adverse outcomes. FUNDunding Acknowledgement Type of funding sources: Foundation. Main funding source(s): This work was supported in part by the American Medical Society for Sports Medicine (AMSSM) Foundation Research Grant 2016 awarded to KE, and the University of Florida REDCap uses the NIH National Center for Advancing Translational Sciences (NCATS) grant UL1 TR001427. Figure 1 Figure 2. LV geometry in female swimmers


2021 ◽  
Vol 10 (12) ◽  
pp. 2554
Author(s):  
Jawwad Hamayun ◽  
Lilly-Ann Mohlkert ◽  
Elisabeth Stoltz Sjöström ◽  
Magnus Domellöf ◽  
Mikael Norman ◽  
...  

Survivors of extremely preterm birth (gestational age < 27 weeks) have been reported to exhibit an altered cardiovascular phenotype in childhood. The mechanisms are unknown. We investigated associations between postnatal nutritional intakes and hyperglycemia, and left heart and aortic dimensions in children born extremely preterm. Postnatal nutritional data and echocardiographic dimensions at 6.5 years of age were extracted from a sub-cohort of the Extremely Preterm Infants in Sweden Study (EXPRESS; children born extremely preterm between 2004–2007, n = 171, mean (SD) birth weight = 784 (165) grams). Associations between macronutrient intakes or number of days with hyperglycemia (blood glucose > 8 mmol/L) in the neonatal period (exposure) and left heart and aortic dimensions at follow-up (outcome) were investigated. Neonatal protein intake was not associated with the outcomes, whereas higher lipid intake was significantly associated with larger aortic root diameter (B = 0.040, p = 0.009). Higher neonatal carbohydrate intake was associated with smaller aorta annulus diameter (B = −0.016, p = 0.008). Longer exposure to neonatal hyperglycemia was associated with increased thickness of the left ventricular posterior wall (B = 0.004, p = 0.008) and interventricular septum (B = 0.004, p = 0.010). The findings in this study indicate that postnatal nutrition and hyperglycemia may play a role in some but not all long-lasting developmental adaptations of the cardiovascular system in children born extremely preterm.


2005 ◽  
Vol 64 (1) ◽  
Author(s):  
Maria Teresa Manes ◽  
Manlio Gagliardi ◽  
Gianfranco Misuraca ◽  
Stefania Rossi ◽  
Mario Chiatto

The aim of this study was to estimate the impact and prevalence of left ventricular geometric alterations and systolic and diastolic dysfunction in hemodialysis patients, as well as the relationship with cardiac troponin as a marker of myocardial damage. Methods: 31 patients (pts), 19 males and 12 females, age 58.1±16.4 (26 on hemodialysis, 5 on peritoneal dialysis) and 31 healthy normal controls were enrolled. Echocardiography measurements were carried out according to the American Society of Echocardiography recommendations. Left ventricular mass was calculated, according to the Devereux formula and indexed to height and weight 2.7. Doppler echocardiography was performed to study diastolic function by measurements of isovolumetric relaxation period (IVRT), E wave deceleretion time (DTE) and E/A ratio. Cardiac troponin was measured by a third generation electrochemiluminescence immunoassay. Statistical analysis was performed using the t-test for between-group comparisons and the Pearson and Spearman’s tests to investigate correlations; p values of &lt;0.05 were considered statistically significant. Results: Eccentric hypertrophy was the most frequent pattern (n=17; 55%), followed by normal cardiac geometry (n=7; 23%), and concentric hypertrophy (n=5; 16%). Only 6% of pts (n=2) showed concentric remodelling. Systolic dysfunction was present in terms of endocardial parameters in 3 pts (9%) (fractional shartening &lt;25%, EF&lt;50%), but in terms of midwall myocardial shortening in 51% (n=16). Diastolic dysfunction was present in 87% (n=27) with a pattern of impaired relaxation (in 5 without left ventricular hypertrophy). E/A was negatively correlated with age (r=-0.41, p=0.02); DTE was positively correlated with posterior wall thickness (r=0.36, p=0.05) and interventricular septum thickness (r=0.45, p=0.01); cardiac troponin was positively correlated with age (r=0.50, p=0.00), left ventricular mass (r=0.41, p=0.02), posterior wall thickness (r=0.41; p=0.02) and interventricular septum thickness (r=0.39, p=0.03) but not with diastolic dysfunction parameters. No significant difference was found in terms of duration of dialysis between patients with normal left ventricular geometry and those with left ventricular hypertrophy, but a significant difference in age was found (p=0.03). Pts with diastolic dysfunction had more frequent hypotensive episodes during dialysis (p &lt;0.01). Conclusion: Impaired geometry and cardiac function is frequently observed in pts undergoing hemodialysis. Diastolic dysfuction is associated to a geometric pattern of left ventricular hypetrophy, although it can be an isolated initial manifestation of myocardial damage. Depressed midwall myocardial shortening can discriminate left ventricular dysfunction better than traditional endocardial systolic indexes.


2016 ◽  
Vol 45 (4) ◽  
pp. 171
Author(s):  
Ria Nova ◽  
Bambang Madiyono ◽  
Sudigdo Sastroasmoro ◽  
Damayanti R Sjarif

Background Obesity causes cardiovascular disturbances. Theincidence of cardiovascular disease is higher even in mildly obesepatients than in lean subjects.Objectives The purpose of this study was to compare left ven-tricular (LV) mass, LV internal dimensions, and LV systolic func-tion between obese and normal children; and to determine the as-sociation of the degree of obesity with LV mass and LV systolicfunction.Methods This cross-sectional study was conducted on elemen-tary school students in Jakarta from February to April 2003. Wemeasured the subjects’ body weight and height, and performedlipid profile and echocardiography examinations. Measurementsof LV mass, LV internal dimensions with regard to septum thick-ness, LV internal diameter, and LV posterior wall thickness; andLV systolic function as indicated by shortening fraction and ejec-tion fraction, were performed echocardiographically. The differ-ences in measurements between obese and normal children aswell as between obese children with and without lipid abnormalitywere analyzed. The correlation between the degree of obesity withLV size and systolic function was determined.Results Twenty-eight normal children and 62 obese children wereenrolled in the study. Mean LV mass was 35.7 (SD 5.16) g/cm 3 inobese children versus 24.0 (SD 3.80) g/cm 3 in normal children(P<0.0001). Mean septum thickness was 0.8 (SD 0.14) mm inobese children versus 0.6 (SD 7.90) mm in normal children (P<0.0001). Mean posterior wall thickness was 0.9 (SD 0.14) mm inobese children versus 0.6 (SD 9.97) mm in normal children(P<0.0001). Mean LV internal diameter was 4.0 (SD 0.34) mm inobese children versus 3.9 (SD 0.29) mm in normal children(P=0.300). There was strong correlation between the degree ofobesity and LV mass (r=0.838, P<0.0001). LV systolic function(shortening fraction) was 37.1 (SD 4.20) percent in obese childrenversus 35.8 (SD 4.99) percent in normal children (P=0.19). Ejec-tion fraction was 67.4 (SD 5.32) percent in obese children versus65.5 (SD 6.29) percent in normal children (P=0.13). There wasweak correlation between LV systolic function and the degree ofobesity (shortening fraction r=0.219, P=0.038; ejection fractionr=0.239, P=0.023).Conclusions Obese children had significantly greater LV mass,septum thickness, and posterior wall thickness than normal chil-Backgrounddren. Such significant difference was absent for LV internal diam-eter and measures of LV systolic function. There was no signifi-cant difference in LV mass and LV systolic function between obesechildren with or without abnormality of lipid profile. A strong corre-lation exists between the degree of obesity and LV mass, but thecorrelation between degree of obesity and LV systolic function wasweak


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Dharmendrakumar A Patel ◽  
Carl J Lavie ◽  
Sangeeta Shah ◽  
Yvonne Gilliland ◽  
Richard V Milani

Background: Several studies have indicated that left ventricular (LV) geometric patterns predict cardiovascular events. However, little data is available that compares the relative prognostic impact of LV mass index (LVMI) and relative wall thickness (RWT) on mortality in a large cohort of patients with preserved systolic function. Methods: The impact of LVMI and RWT on mortality during an average follow-up of 1.7±1.0 years was examined in a sample of 47,701 patients (mean age: 61.6 ± 15.4; females=54.6 %) with preserved ejection fraction(EF), as well as in age groups of <50 yrs(n=10,864; mean age=39.9 ± 8.1; females=58.4 %), 50 –70 yrs (n=20,181; mean age=59.9 ± 5.7; females=52.2 %) and >= 70 yrs (n=16,836; mean age=77.7 ± 5.5; females=55.1 %). Results: With increasing age (<50, 50 –70, >=70 yrs), both LVMI (78.5 ± 23.4, 84.3 ± 25.4, 90.3 ± 27.6; p<0.0001) and RWT (0.37 ± 0.08, 0.41 ± 0.08, 0.43 ± 0.09; p<0.0001) as well as mortality (2.2%, 5.0%, 14.2%; p<0.0001) showed significant linear trends and were independent predictors of mortality (Table , Figure ). Conclusion: Although, both LVMI and RWT were independently associated with increased mortality in all groups, RWT was by far the strongest independent predictor of all-cause mortality, especially in younger patients.


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