Use of thyroid hormones in the treatment of cardiovascular diseases: literature review

Cardiovascular diseases remain the leading cause of death all over the world. Thyroid hormones play a significant role in the regulation of cardiac function. According to a number of researches, patients with cardiovascular diseases usually have a decrease in the concentration of thyroid hormones in the blood serum, which may be associated with a poor prognosis. Today it still remains unclear whether the change in the bioavailability of thyroid hormones in the myocardium is a favorable physiological mechanism or a replication of an adaptation disorder. Experimental researches suggest that thyroid hormone therapy may be applied in clinical cardiology. This review describes the results of researches examining the use of thyroid hormones in patients with cardiovascular diseases, as well as experiment data on animal models. The available data on the use of thyroid hormones in patients with acute myocardial infarction and heart failure allow us to suggest that normalization of thyroid hormone levels is a safe and potentially effective treatment method in the group of patients with cardiovascular disease. At the same time, the data on the use of thyroid hormones in patients who have undergone an open-heart surgery or heart transplantation are limited. However, at present, it is difficult to draw unambiguous conclusions about the benefits, as well as about the possible risk of using thyroid hormones in the described conditions. Large-scale clinical researches are required to confirm the safety and evaluate the effectiveness of such therapy. Moreover, it is necessary to set parameters for evaluating the safety and effectiveness and understand which hormone (thyroxine or triiodothyronine), what dosage and at what stage of the disease should be applied. Until we do not have answers for these questions, thyroid hormone therapy in patients with cardiovascular diseases should remain within the research field.

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Novel uses of thyroid hormones in cardiovascular conditions

Endocrine ◽

10.1007/s12020-019-02050-4 ◽

2019 ◽

Vol 66 (1) ◽

pp. 115-123 ◽

Cited By ~ 6

Author(s):

Salman Razvi

Keyword(s):

Cardiovascular Diseases ◽

Thyroid Hormone ◽

Thyroid Hormones ◽

Hormone Therapy ◽

Large Scale ◽

Experimental Studies ◽

Hormone Treatment ◽

Limited Data ◽

Hormone Levels ◽

Thyroid Hormone Levels

Abstract Thyroid hormone levels are reduced in cardiovascular diseases and this phenomenon is associated with worse outcomes. It is unclear whether the changes in thyroid hormone bioavailability to the affected myocardium are beneficial or if this is a maladaptive response. Experimental studies from animal models of acute myocardial infarction (AMI) suggest that thyroid hormone treatment may be beneficial. There is limited data available on the use of thyroid hormones in patients with AMI and heart failure and this suggests that treatment to normalise thyroid hormone levels may be safe and potentially efficacious. Similarly, evidence of thyroid hormone therapy in patients undergoing cardiac surgery or during cardiac transplantation is limited. It is therefore difficult to draw any firm conclusions about benefits or risks of thyroid hormone treatment in these conditions. Large scale clinical trials of thyroid hormones in patients with cardiac conditions are required to confirm safety and evaluate efficacy. Furthermore, it needs to be elucidated which hormone to administer (thyroxine or triiodothyronine), when in the disease pathway to treat, dose of thyroid hormone to administer, and which parameters to utilise to assess safety and efficacy. Until these important questions are answered thyroid hormone therapy in cardiovascular diseases must remain within the research domain.

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Evaluation of Positive Inotropic Drug Effects on Thyroid Hormone Levels after Open Heart Surgery

The Heart Surgery Forum ◽

10.1532/hsf98.20121084 ◽

2015 ◽

Vol 16 (2) ◽

pp. 78

Author(s):

Umit Kervan ◽

Anil Ozen ◽

Utku Unal ◽

Irfan Tasoglu ◽

Mahmut Mustafa Ulas ◽

...

Keyword(s):

Drug Therapy ◽

Thyroid Hormone ◽

Heart Surgery ◽

Open Heart Surgery ◽

Open Heart ◽

Inotropic Drug ◽

Hormone Levels ◽

Inotropic Drugs ◽

Positive Inotropic Drug ◽

Thyroid Hormone Levels

Objective: The aim of this study was to examine the effects of positive inotropic drugs, including adrenaline, dopamine, and dobutamine on thyroid hormone levels following open heart surgery.Methods: We analyzed free thyroid hormones (FT3 and FT4) and thyroid-stimulating hormones (TSH) in 200 consecutive patients undergoing open heart surgery. Patients were divided into 5 groups according to the inotropic drug administration as follows: Group A (n = 46) received dopamine alone; Group B (n = 40), dopamine and dobutamine; Group C (n = 36), dopamine, dobutamine, and adrenaline; Group D (n = 32), adrenaline alone; and Group E (n = 46), placebo. Procedural factors affecting thyroid hormones were recorded and included cardiopulmonary bypass (CPB) time, cross-clamping time, degree of hypothermia, and the duration and doses of positive inotropic drugs. Blood samples for hormone assays were collected before initiation of inotropic drug therapy (baseline) and postoperatively at 24, 72, and 120 hours after drug therapy.Results: FT3, FT4, and TSH levels at baseline were similar in all groups. Although there was a trend showing very slight increases in thyroid hormone levels from baseline to the 24th, 72nd, and 120th postoperative hours after drug therapy, these changes were not significant, and there were also no significant differences between the groups. There was also no significant statistical difference in CPB time, cross-clamping time, degree of hypothermia, and duration and doses of positive inotropic drugs between groups.Conclusion: Although thyroid hormone levels were affected by positive inotropic drug usage after open heart surgery, this effect was not significant and thyroid hormone levels remained within normal ranges.

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LINGUAL AND SUBLINGUAL THYROID GLANDS IN EUTHYROID CHILDREN

PEDIATRICS ◽

10.1542/peds.38.4.647 ◽

1966 ◽

Vol 38 (4) ◽

pp. 647-651

Author(s):

Wellington Hung ◽

Judson G. Randolph ◽

Domenic Sabatini ◽

Theodore Winship

Keyword(s):

Thyroid Hormone ◽

Thyroid Gland ◽

Physical Examination ◽

Thyroid Hormones ◽

Hormone Therapy ◽

Surgical Intervention ◽

Ectopic Thyroid ◽

Lingual Thyroid ◽

Thyroid Glands ◽

Careful Physical Examination

Five clinically euthyroid children with lingual or sublingual thyroid glands were seen during a 12-month period. Certain recommendations have been formulated based upon our experience with these patients. A careful physical examination should be performed to demonstrate the presence of a normally located thyroid gland in all children presenting with midline masses in the lingual or sublingual areas. When the thyroid gland cannot be palpated with certainty in these children, a scintiscan with I-131 should be carried out to determine if the mass is an ectopic thyroid gland and if a normally located thyroid gland is present. All children with lingual on sublingual thyroid glands should have a trial of full replacement thyroid hormone therapy before excision is contemplated. Thyroid therapy will prevent further hypertrophy and hyperplasia. Surgical intervention should be reserved for those children in whom there is dysphagia, dysphonia, ulceration, or hemorrhage due to a lingual thyroid gland or if the ectopic thyroid gland fails to decrease in size following a course of treatment with thyroid hormones.

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Thyroid hormone supplementation following open-heart surgery in children

Indian Journal of Thoracic and Cardiovascular Surgery ◽

10.1007/s12055-015-0411-4 ◽

2015 ◽

Vol 32 (1) ◽

pp. 17-22

Author(s):

Sachin Talwar ◽

Manikala Vinod Kumar ◽

Shiv Kumar Choudhary ◽

Balram Airan

Keyword(s):

Thyroid Hormone ◽

Heart Surgery ◽

Open Heart Surgery ◽

Open Heart

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The Anesthesia & Anesthetists of the First Open Heart Surgery of Bangladesh

Bangladesh Heart Journal ◽

10.3329/bhj.v36i1.55518 ◽

2021 ◽

Vol 36 (1) ◽

pp. 55-60

Author(s):

Suman Nazmul Hosain ◽

Farzana Amin ◽

Shahnaz Ferdous

Keyword(s):

College Student ◽

Cardiovascular Diseases ◽

Human Resources ◽

Heart Surgery ◽

Septal Defect ◽

Open Heart Surgery ◽

Open Heart ◽

Success Story ◽

Direct Closure ◽

Over Time

Although a few closed heart operations were performed in the late 1960s, well organized approach to open heart surgery began in Bangladesh only after establishment of Institute of Cardiovascular Diseases (ICVD) in 1978. A Japanese team of surgeons, anesthetists, nurses and technicians provided extensive support in capacity building of the local human resources. Ultimately the first open heart surgery of Bangladesh, the direct closure of Atrial Septal Defect of an 18 year old college student, was performed on 18th September 1981. It was great news of that time. People came to know about the success story of the ICVD director then Colonel M Abdul Malik, a renowned cardiologist cum team leader and the Bangladeshi surgeon duo Dr M Nabi Alam Khan and Dr S R Khan. But somehow the anesthetists, an important part of the team were out of focus and have been forgotten over time. Led by Prof Khalilur Rahman, the anesthetist team of the day included Dr Nurul Islam, Dr Abdul Hadi, Dr Delowar Hossain, Dr A Y F Ellahi Chowdhury and Dr Monir Hossain. This article is an attempt to remind their contribution and expressing respect and gratitude to the anesthetists of that pioneering team. Bangladesh Heart Journal 2021; 36(1) : 55-60

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THYROID HORMONE THERAPY AND TREATMENT FOR WOMEN’S ABOVE 30 YEAR OLD WITH HYPOTHYROIDISM

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i3.1014 ◽

2020 ◽

Vol 4 (3) ◽

Author(s):

N Rawat ◽

S Saxena

Keyword(s):

Immune System ◽

Thyroid Hormone ◽

Side Effects ◽

Thyroid Hormones ◽

Hormone Therapy ◽

Free Thyroxine ◽

Substitution Treatment ◽

Free Triiodothyronine ◽

Typical Condition ◽

Serum Tsh

Thyroid hormones impact every single significant organ/frameworks and sufficient levels are significant for ideal capacity. Thyroid brokenness is a typical condition that effects somewhere in the range of 3 and 21% of the populace with predominance being increasingly regular in ladies and in more established people. Hypothyroidism is characterized by the expansion in thyroid-animating hormone (TSH) values, joined by diminished coursing free triiodothyronine (FT3) and free thyroxine (FT4). TSH is the most solid marker of sufficiency of substitution treatment, and an incentive inside the reference run (0.4–4.0 mIU/L) ought to be viewed as the helpful objective" have serum TSH esteems somewhere in the range of 0.4 and 2.5 mU/L. It is thusly contended that TSH esteems > 2.5 mU/L reflect hidden immune system thyroid ailment and add to the slanted TSH dissemination bend, a view additionally bolstered by the way that such people have a higher danger of movement to ensuing hypothyroidism. In this way, side effects of hypothyroidism are inadequate and vague in more established individuals. This prompts thyroid capacity tests being as often as possible mentioned. Then again, high thyroid capacity, as confirm by a low TSH level needs cautious observing and treatment considered if there is proof of end-organ harm, (for example, osteoporosis or AF), or if serum TSH is stifled. Keywords: TSH, Thyroid hormones, Hypothyroidism, FT4.

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Role of Thyroid Hormone and Oxidant Stress in Cardiovascular Diseases

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530320666200917114501 ◽

2020 ◽

Vol 20 ◽

Author(s):

Mobidullah Khan ◽

Suchismita Mukherjee ◽

Sarbashri Bank ◽

Smarajit Maiti

Keyword(s):

Oxidative Stress ◽

Uric Acid ◽

Blood Glucose ◽

Cardiovascular Diseases ◽

Thyroid Hormone ◽

High Risk ◽

Thyroid Hormones ◽

High Glucose ◽

Oxidant Stress ◽

High Cholesterol

Background: Cardiovascular-diseases (CVD) are caused by different metabolic-anomalies related to hypertension/sedentary life-style/drug-addiction/dyslipidemia and diabetes. Scanty report suggests that metabolic-rate regulating thyroid hormones are linked to CVD. Methods: A total 59 individuals (male, >45 yrs) were involved in this study. Blood-samples from diagnosed cardiacpatients troponin (N=13, trop-T+), individuals with high-risk (N=15) (high glucose/cholesterol/triglycerides) with agematched controls (N=31) were tested for the evaluation of lipid-profiles/thyroid-hormones; Triiodothyronine, Thyroxine and thyroid stimulating hormone (T3/T4/TSH), blood-glucose/oxidative-stress indicators like malondialdehyde(MDA)/non-protein-soluble-thiol(NPSH) and metabolic inflammatory-marker; human C-reactive protein hsCRP by biochemical-methods/ELISA. Result: Correlation-data suggest that in normal-condition there is no significant correlation between thyroid-hormones and other parameters. In contrary, blood-glucose/triglyceride/uric-acid/proteins are correlated in cardiac and high-risk patients suggesting hypermetabolic conversion of nutrients by biochemical connectors like TCA cycle and gluconeogenesis pathways. Further, the hypermetabolic-state is favored by the rise in the thyroid hormones level. In high-glucose group there is a significant correlation between metabolic-parameter and oxidative-stress indices like uric-acid/NPSH/MDA. T3 and T4 have also been linked to the serum-protein. But in the trop t+ group all thyroid hormones have been significantly associated with blood cholesterol/triglyceride and glucose suggesting the increasing involvement of thyroid-hormone in risk-factors and disease groups. The hsCRP level was ~100% and ~5-fold higher in high cholesterol and trop t+ groups, respectively. T3 was also ~70%, ~4.5-fold and ~3.5-fold higher in high-glucose/high-cholesterol/trop-t+ groups, respectively. This suggests that T3/TSH is linked to the pathogenesis and severity. Conclusion: Dyslipidemia, oxidant-stress in association with T3 augment cardiac-pathogenesis.

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Thyroid hormone abnormalities and neonates undergoing open-heart surgery

Pediatric Anesthesia ◽

10.1111/j.1460-9592.2006.02087.x ◽

2007 ◽

Vol 17 (3) ◽

pp. 300-301 ◽

Cited By ~ 2

Author(s):

Oliver Ross

Keyword(s):

Thyroid Hormone ◽

Heart Surgery ◽

Open Heart Surgery ◽

Open Heart

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Nanomedicine in diagnostics and therapy of cardiovascular diseases: beyond atherosclerotic plaque imaging

Nanotechnology Reviews ◽

10.1515/ntrev-2013-0009 ◽

2013 ◽

Vol 2 (4) ◽

pp. 449-472 ◽

Cited By ~ 12

Author(s):

Iwona Cicha ◽

Stefan Lyer ◽

Christoph Alexiou ◽

Christoph D. Garlichs

Keyword(s):

Cardiovascular Diseases ◽

Heart Surgery ◽

Vascular Tissue ◽

Open Heart Surgery ◽

Clinical Manifestations ◽

Current Therapy ◽

Systemic Delivery ◽

Stent Restenosis ◽

Modified Lipoproteins ◽

Inflammatory Processes

AbstractAtherosclerosis results from the accumulation of the modified lipoproteins within the artery walls, which triggers complex vascular inflammatory processes. Although the pharmacologic agents for the treatment of clinical manifestations of atherosclerosis are available, their systemic delivery has serious disadvantages, such as considerable side effects or low efficacy at tolerated doses. Moreover, the treatment of atherosclerosis using the interventional techniques bears further shortcomings: the implanted stents require a lengthy antiplatelet therapy and carry the risk of in-stent restenosis. In the surgical approach to atherosclerosis, apart from the overall risk of open heart surgery, the lack of adequate venous material for bypasses constitutes a common problem. The nanotechnology has the potential to overcome the disadvantages of the current therapy of atherosclerosis, e.g., by the formation of nanosized assemblies for the earlier detection of atherosclerotic lesions and for cell-specific delivery of therapeutics. Replacing the current systemic pharmacological approach by a locally targeted treatment of plaques can substantially minimize the adverse effects, by lowering the drug cytotoxicity and reducing the required dosage. Moreover, a new generation of nanotechnological approaches to the revascularization procedures is now emerging, e.g., vascular tissue engineering utilizing the magnetic nanoparticles or the design of stents with the reduced risk of thrombosis and restenosis. This review discusses the possible applications of the nanomedical approaches in the treatment of cardiovascular diseases.

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