scholarly journals Thyroid Hormones—An Underestimated Player in Dilated Cardiomyopathy?

2021 ◽  
Vol 10 (16) ◽  
pp. 3618
Author(s):  
Karolina Zawadzka ◽  
Radosław Dziedzic ◽  
Andrzej Surdacki ◽  
Bernadeta Chyrchel
Keyword(s):  
Thyroid Hormones ◽  
Dilated Cardiomyopathy ◽  
Systolic Dysfunction ◽  
Thyroid Stimulating Hormone ◽  
Left Ventricular ◽  
Thyroid Status ◽  
Free Triiodothyronine ◽  
Beneficial Effects ◽  
Low T3 ◽  
Altered Thyroid

Dilated cardiomyopathy (DCM) is the most prevalent cardiomyopathy, typified by left ventricular dilation and systolic dysfunction. Many patients with DCM have altered thyroid status, especially lower levels of free triiodothyronine (T3) and elevated levels of thyroid-stimulating hormone. Moreover, growing evidence indicates that even subtle changes in thyroid status (especially low T3) are linked with a worse long-term prognosis and a higher risk of mortality. Notably, recent discoveries have shown that not only local myocardial thyroid hormones (THs) bioavailability could be diminished due to impaired expression of the activating deiodinase, but virtually all genes involved in TH biosynthesis are also expressed in the myocardium of DCM patients. Importantly, some studies have suggested beneficial effects of TH therapy in patients suffering from DCM. Our aim was to discuss new insights into the association between TH status and prognosis in DCM, abnormal expression of genes involved in the myocardial synthesis of TH in DCM, and the potential for TH use in the future treatment of DCM.

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.

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.

scholarly journals Torsion Mechanics as an Indicator of More Advanced Left Ventricular Systolic Dysfunction in Secondary Mitral Regurgitation in Patients with Dilated Cardiomyopathy: A 2D Speckle-Tracking Analysis

Cardiology ◽  
2018 ◽  
Vol 139 (3) ◽  
pp. 187-196 ◽  
Author(s):  
Elena Kinova ◽  
Natalia Spasova ◽  
Angelina Borizanova ◽  
Assen Goudev
Keyword(s):  
Mitral Regurgitation ◽  
Dilated Cardiomyopathy ◽  
Speckle Tracking ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Functional Mitral Regurgitation ◽  
Compensatory Mechanism ◽  
Structural Wall ◽  
Group 2 ◽  
Group 1

Left ventricular (LV) twist serves as a compensatory mechanism in systolic dysfunction and its degree of reduction may reflect a more advanced stage of disease. Aim: The aim was to investigate twist alterations depending on the degree of functional mitral regurgitation (MR) by speckle-tracking echocardiography. Methods: Sixty-three patients with symptomatic dilated cardiomyopathy (DCM) were included. Patients were divided according to MR vena contracta width (VCW): group 1 with VCW <7 mm (mild/moderate MR) and group 2 with VCW ≥7 mm (severe MR). Results: There were no differences in LV geometry and function between groups. Group 2 showed lower endocardial basal rotation (BR) (–2.04° ± 1.83° vs. –3.23° ± 1.83°, p = 0.012); epicardial BR (–1.54° ± 1.18° vs. –2.31° ± 1.22°, p = 0.015); endocardial torsion (0.41°/cm ± 0.36°/cm vs. 0.63°/cm ± 0.44°/cm, p = 0.033) and mid-level circumferential strain (CSmid) (–6.12% ± 2.64% vs. –7.75% ± 2.90%, p = 0.028), when compared with group 1. Multivariable linear regression analysis identified endocardial BR, torsion and CSmid, as the best predictors of larger VCW. In the ROC curve analysis, endocardial BR and CSmid values greater than or equal to –3.63° and –9.35%, respectively, can differentiate patients with severe MR. Conclusions: In DCM patients, torsional profile was more altered in severe MR. Endocardial BR, endocardial torsion, and CSmid, can be used as indicators of advanced structural wall architecture damage.

P595Characteristics of the right ventricle in patients with nonischemic dilated cardiomyopathy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Becker ◽  
C P Allaart ◽  
M Wubben ◽  
J H Cornel ◽  
A C Van Rossum ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Right Ventricular ◽  
Dilated Cardiomyopathy ◽  
Ventricular Function ◽  
Left Atrial ◽  
Systolic Dysfunction ◽  
Underlying Mechanism ◽  
Left Ventricular ◽  
End Diastolic Volume ◽  
Nonischemic Dilated Cardiomyopathy

Abstract Background In nonischemic dilated cardiomyopathy (DCM), diagnosis and prognosis is based on left ventricular function. Although concomitant right ventricular (RV) dysfunction is frequently observed, the underlying mechanism is currently not fully understood. Purpose We aimed to describe the characteristics of right ventricular function in DCM patients with cardiac magnetic resonance (CMR) imaging using cine and late-gadolinium enhancement (LGE) imaging. Methods Patients with DCM and left ventricular (LV) dysfunction (ejection fraction (EF) <50%) on LGE-CMR were included prospectively. LV and RV volumes and function were quantified and RV systolic dysfunction was defined as RV ejection fraction (RVEF)<45%. The presence and pattern of LGE were assessed visually and the extent was quantified using the full-width half maximum method. Septal midmyocardial LGE pattern was defined as midwall striae or hinge-point myocardial hyperenhancement. Moreover, left atrial (LA) volumes were calculated using the bi-plane area-length method. Results The study included 214 DCM patients (42% female, age 58±14 years) with a mean LVEF of 34±12% and RVEF of 46±12%. RV systolic dysfunction was present in 39% and was associated with the presence of septal midwall LGE (OR 1.96 (95% CI 1.09–3.54) p=0.026). In patients with RV dysfunction, LV dilation was more severe (LV end diastolic volume (EDV) 242±97mL vs. 212±58mL, p=0.011) and LVEF was lowere (26±12% vs. 39±8%, p<0.001) (figure A). There was a weak correlation between septal LGE amount and LVEDV and RVEDV (respectively r=0.36, p=0.003 and r=0.35, p=0.005) In patients with RV dysfunction, left atrial volumes were enlarged (56±23mL/m2 vs. 46±14mL/m2, p<0.001) and LA emptying fraction was moderately correlated to RVEF (figure B), also after exclusion of patients with a history of atrial fibrillation. RVEF in DCM patients Conclusion In DCM, reduced RVEF predominantly occurred in patients with a) LVEF lower than 30%, b) septal midwall enhancement, indicating progressive LV remodeling, c) LA dilation and d) LA dysfunction. This suggests that RV dysfunction in advanced DCM is drive by LV diastolic dysfunction resulting in increased afterload of the RV.

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 Impact of thyroid hormones on asthma in older adults

2019 ◽  
Vol 47 (9) ◽  
pp. 4114-4125 ◽  
Author(s):  
Zhan Bingyan ◽  
Wei Dong
Keyword(s):  
Respiratory Failure ◽  
Thyroid Hormones ◽  
Pulmonary Function ◽  
Correlation Coefficients ◽  
Forced Expiratory Volume ◽  
Thyroid Stimulating Hormone ◽  
Type I ◽  
Free Triiodothyronine ◽  
Specific Effects ◽  
Total Thyroxine

Objective Thyroid hormones affect airway contraction, but the specific effects of thyroid hormones on airways are controversial. Methods We divided 78 advanced-age men with asthma into 3 groups: type I respiratory failure (RF1), type II respiratory failure (RF2), and no respiratory failure (NRF). Pulmonary function was measured after asthma stabilization. Results The free triiodothyronine (FT3) level was significantly higher in the RF1 than RF2 group, but the free thyroxine (FT4), total thyroxine (TT4), and thyroid-stimulating hormone (TSH) levels were not significantly different. In the RF1, RF2, and NRF groups, the correlation coefficients between FT3 and the forced expiratory volume in1 s (FEV1) were 0.317, 0.627, and 0.213; those between FT3 and the FEV1/forced vital capacity (FVC) ratio were 0.287, 0.412, and 0.156; those between FT4 and FEV1 were 0.214, 0.231, and 0.167; and those between FT4 and the FEV1/FVC ratio were 0.211, 0.215, and 0.218, respectively. In the RF1 and RF2 groups, the correlation coefficients between the sum activity of peripheral deiodinases (SPINA-GD) and the FEV1/FVC ratio were 0.164 and 0.421, and those between SPINA-GD and FEV1 were 0.284 and 0.491, respectively. Conclusion The correlation between FT3 and pulmonary function is likely caused by changes in thyroid enzymology.

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