https://doi.org/10.4081/monaldi.2022.2145
Thyroid dysfunction on the heart: clinical effects, prognostic impact and management strategies
Submitted: November 7, 2021
Accepted: March 8, 2022
Published: March 24, 2022
Accepted: March 8, 2022
Abstract Views: 1533
PDF: 552
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Thyroid hormones have a considerable influence on cardiac function and structure. There are direct and indirect effects of thyroid hormone on the cardiovascular system, which are prominent in both hypothyroidism and hyperthyroidism. In this review, we discuss how thyroid dysfunction impacts cardiovascular pathophysiology and the underlying molecular mechanisms.
Irace L, Pergola V, Di Salvo G, et al. Work capacity and oxygen uptake abnormalities in hyperthyroidism. Minerva Cardioangiol 2006;54:355-62.
Biondi B. Mechanisms in endocrinology: Heart failure and thyroid dysfunction. Eur J Endocrinol 2012;167:609–18.
DOI: https://doi.org/10.1530/EJE-12-0627
Mitchell JE, Hellkamp AS, Mark DB, et al. Thyroid function in heart failure and impact on mortality. JACC Heart Fail 2013;1:48–55.
DOI: https://doi.org/10.1016/j.jchf.2012.10.004
Cittadini A, Salzano A, Iacoviello M, et al. Multiple hormonal and metabolic deficiency syndrome predicts outcome in heart failure: the T.O.S.CA. Registry. Eur J Prev Cardiol 2021;28:1691-700.
DOI: https://doi.org/10.1093/eurjpc/zwab020
Iervasi G, Pingitore A, Landi P, et al. Low-T3 syndrome: a strong prognostic predictor of death in patients with heart disease. Circulation 2003;107:708–13.
DOI: https://doi.org/10.1161/01.CIR.0000048124.64204.3F
Kannan L, Shaw PA, Morley MP, et al. Thyroid dysfunction in heart failure and cardiovascular outcomes. Circ Heart Fail 2018;11:e005266.
DOI: https://doi.org/10.1161/CIRCHEARTFAILURE.118.005266
Klein I, Danzi S. Thyroid disease and the heart. Circulation 2007;116:1725–35.
DOI: https://doi.org/10.1161/CIRCULATIONAHA.106.678326
Tomisti L, Materazzi G, Bartalena L, et al. Total thyroidectomy in patients with amiodarone-induced thyrotoxicosis and severe left ventricular systolic dysfunction. J Clin Endocrinol Metab 2012;97:3515–21.
DOI: https://doi.org/10.1210/jc.2012-1797
Al-Ghamdi AS, Aljohani N. Graves’ thyrotoxicosis-induced reversible cardiomyopathy: a case report. Clin Med Insights Case Rep 2013;6:47–50.
DOI: https://doi.org/10.4137/CCRep.S10534
Choudhury RP, MacDermot J. Heart failure in thyrotoxicosis, an approach to management. Br J Clin Pharmacol 1998;46:421–4.
DOI: https://doi.org/10.1046/j.1365-2125.1998.00804.x
Osman F, Franklyn JA, Holder RL, et al. Cardiovascular manifestations of hyperthyroidism before and after antithyroid therapy: a matched case-control study. J Am Coll Cardiol 2007;49:71–81.
DOI: https://doi.org/10.1016/j.jacc.2006.08.042
Salzano A, Marra A., Ferrara F. Multiple hormone deficiency syndrome in heart failure with preserved ejection fraction. Int J Cardiol 2016;225:1-3.
DOI: https://doi.org/10.1016/j.ijcard.2016.09.085
Bastenie PA, Vanhaelst L, Neve P. Coronary-artery disease in hypothyroidism. Lancet 1967;2:1221–2.
DOI: https://doi.org/10.1016/S0140-6736(67)90562-4
Tanis BC, Westendorp GJ, Smelt HM. Effect of thyroid substitution on hypercholesterolaemia in patients with subclinical hypothyroidism: a reanalysis of intervention studies. Clin Endocrinol (Oxf) 1996;44:643–9.
DOI: https://doi.org/10.1046/j.1365-2265.1996.739560.x
Wei JY, Genecin A, Greene HL, Achuff SC. Coronary spasm with ventricular fibrillation during thyrotoxicosis: response to attaining euthyroid state. Am J Cardiol 1979;43:335–9.
DOI: https://doi.org/10.1016/S0002-9149(79)80023-5
Woeber KA. Thyrotoxicosis and the heart. N Engl J Med 1992;327:94–8.
DOI: https://doi.org/10.1056/NEJM199207093270206
Siu C-W, Zhang X-H, Yung C, et al. Hemodynamic changes in hyperthyroidism-related pulmonary hypertension: a prospective echocardiographic study. J Clin Endocrinol Metab 2007;92:1736–42.
DOI: https://doi.org/10.1210/jc.2006-1877
Sugiura T, Yamanaka S, Takeuchi H, et al. Autoimmunity and pulmonary hypertension in patients with Graves’ disease. Heart Vessels 2015;30:642–6.
DOI: https://doi.org/10.1007/s00380-014-0518-3
Vallabhajosula S, Radhi S, Cevik C, et al. Hyperthyroidism and pulmonary hypertension: an important association. Am J Med Sci 2011;342:507–12.
DOI: https://doi.org/10.1097/MAJ.0b013e31821790f4
Danzi S, Klein I. Thyroid disease and the cardiovascular system. Endocrinol Metab Clin North Am 2014;43:517–28.
DOI: https://doi.org/10.1016/j.ecl.2014.02.005
Bielecka-Dabrowa A, Mikhailidis DP, Rysz J, Banach M. The mechanisms of atrial fibrillation in hyperthyroidism. Thyroid Res 2009;2:4.
DOI: https://doi.org/10.1186/1756-6614-2-4
Forfar JC, Feek CM, Miller HC, Toft AD. Atrial fibrillation and isolated suppression of the pituitary-thyroid axis: response to specific antithyroid therapy. Int J Cardiol 1981;1:43–8.
DOI: https://doi.org/10.1016/0167-5273(81)90047-4
Sawin CT, Geller A, Wolf PA, et al. Low serum thyrotropin concentrations as a risk factor for atrial fibrillation in older persons. N Engl J Med 1994;331:1249–52.
DOI: https://doi.org/10.1056/NEJM199411103311901
Forfar JC, Miller HC, Toft AD. Occult thyrotoxicosis: a correctable cause of ‘idiopathic’ atrial fibrillation. Am J Cardiol 1979;44:9–12.
DOI: https://doi.org/10.1016/0002-9149(79)90243-1
Vargas-Uricoechea H, Bonelo-Perdomo A, Sierra-Torres CH. Effects of thyroid hormones on the heart. Clin Investig Arterioscler 2014;26:296–309.
DOI: https://doi.org/10.1016/j.arteri.2014.07.003
Tănase DM, Ionescu SD, Ouatu A, et al. Risk assessment in the development of atrial fibrillation at patients with associate thyroid dysfunctions. Rev Med Chir Soc Med Nat Iasi 2013;117:623-9.
Chaker L, Heeringa J, Dehghan A, et al. Normal thyroid function and the risk of atrial fibrillation: the Rotterdam study. J Clin Endocrinol Metab 2015;100:3718–24.
DOI: https://doi.org/10.1210/jc.2015-2480
Staffurth JS, Gibberd MC, Fui SN. Arterial embolism in thyrotoxicosis with atrial fibrillation. Br Med J 1977;2:688–90.
DOI: https://doi.org/10.1136/bmj.2.6088.688
Frost L, Vestergaard P, Mosekilde L. Hyperthyroidism and risk of atrial fibrillation or flutter: a population-based study. Arch Intern Med 2004;164:1675–8.
DOI: https://doi.org/10.1001/archinte.164.15.1675
Elbers LPB, Fliers E, Cannegieter SC. The influence of thyroid function on the coagulation system and its clinical consequences. J Thromb Haemost 2018;16:634–45.
DOI: https://doi.org/10.1111/jth.13970
Kellett HA, Sawers JS, Boulton FE, et al. Problems of anticoagulation with warfarin in hyperthyroidism. Q J Med 1986;58:43–51.
Goldstein SA, Green J, Huber K, et al. Characteristics and outcomes of atrial fibrillation in patients with thyroid disease (from the ARISTOTLE Trial). Am J Cardiol 2019;124:1406-12.
DOI: https://doi.org/10.1016/j.amjcard.2019.07.046
Surks MI, Ortiz E, Daniels GH, et al. Subclinical thyroid disease: scientific review and guidelines for diagnosis and management. JAMA 2004;291:228–38.
DOI: https://doi.org/10.1001/jama.291.2.228
Biondi B, Palmieri EA, Lombardi G, Fazio S. Effects of subclinical thyroid dysfunction on the heart. Ann Intern Med 2002;137:904–14.
DOI: https://doi.org/10.7326/0003-4819-137-11-200212030-00011
Biondi B, Bartalena L, Cooper DS, et al. The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism. Eur Thyroid J 2015;4:149–63.
DOI: https://doi.org/10.1159/000438750
Nanchen D, Gussekloo J, Westendorp RGJ, et al. Subclinical thyroid dysfunction and the risk of heart failure in older persons at high cardiovascular risk. J Clin Endocrinol Metab 2012;97:852–61.
DOI: https://doi.org/10.1210/jc.2011-1978
Selmer C, Olesen JB, Hansen ML, et al. The spectrum of thyroid disease and risk of new onset atrial fibrillation: a large population cohort study. BMJ 2012;345:e7895.
DOI: https://doi.org/10.1136/bmj.e7895
Selmer C, Olesen JB, Hansen ML, et al. Subclinical and overt thyroid dysfunction and risk of all-cause mortality and cardiovascular events: a large population study. J Clin Endocrinol Metab 2014;99:2372–82.
DOI: https://doi.org/10.1210/jc.2013-4184
Spencer C, Eigen A, Shen D, et al. Specificity of sensitive assays of thyrotropin (TSH) used to screen for thyroid disease in hospitalized patients. Clin Chem 1987;33:1391–6.
DOI: https://doi.org/10.1093/clinchem/33.8.1391
De Groot LJ. Dangerous dogmas in medicine: the nonthyroidal illness syndrome. J Clin Endocrinol Metab 1999;84:151–64.
DOI: https://doi.org/10.1210/jcem.84.1.5364
Hamilton MA, Stevenson LW, Fonarow GC, et al. Safety and hemodynamic effects of intravenous triiodothyronine in advanced congestive heart failure. Am J Cardiol 1998;81:443-7.
DOI: https://doi.org/10.1016/S0002-9149(97)00950-8
Bartalena L, Bogazzi F, Chiovato L, et al. 2018 European Thyroid Association (ETA) Guidelines for the Management of Amiodarone-Associated Thyroid Dysfunction. Eur Thyroid J 2018;7:55-66.
DOI: https://doi.org/10.1159/000486957
Abbara A, Clarke SA, Brewster R, et al. pharmacodynamic response to anti-thyroid drugs in Graves' hyperthyroidism. Front Endocrinol (Lausanne) 2020;11:286.
DOI: https://doi.org/10.3389/fendo.2020.00286
How to Cite
Mattesi, Giulia, Sara Di Michele, Donato Mele, Ilaria Rigato, Riccardo Bariani, Andrea Fiorencis, Marco Previtero, et al. 2022. “Thyroid Dysfunction on the Heart: Clinical Effects, Prognostic Impact and Management Strategies”. Monaldi Archives for Chest Disease 92 (4). https://doi.org/10.4081/monaldi.2022.2145.
Copyright (c) 2022 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Maria Teresa La Rovere, Egidio Traversi, Prognostic impact of digoxin use for rate control of atrial fibrillation in patients ≥75 years of age , Monaldi Archives for Chest Disease: Vol. 88 No. 2 (2018)
- Alberto Genovesi Ebert, Furio Colivicchi, Marco Malvezzi Caracciolo, Carmine Riccio, Additive beneficial effects of beta blockers in the prevention of symptomatic heart failure , Monaldi Archives for Chest Disease: Vol. 72 No. 1 (2009): Cardiac series
- Donatella Del Sindaco, Giovanni Pulignano, Andrea Di Lenarda, Luigi Tarantini, Giovanni Cioffi, Stefano Tolone, Maria Denitza Tinti, Luca Monzo, Giulia Barbati, Giovanni Minardi, Role of a multidisciplinary program in improving outcomes in cognitively impaired heart failure older patients , Monaldi Archives for Chest Disease: Vol. 78 No. 1 (2012): Cardiac series
- Erick Chan, Francesco Giallauria, Carlo Vigorito, Neil A. Smart, Exercise training in heart failure patients with preserved ejection fraction: a systematic review and meta-analysis , Monaldi Archives for Chest Disease: Vol. 86 No. 1-2 (2016): Cardiac series
- Vittorio Palmieri, Antonio Palermo, Patients’ self-evaluation of symptoms, signs and compliance to therapy for heart failure surveillance: A pilot study on identification of worsening heart failure , Monaldi Archives for Chest Disease: Vol. 88 No. 2 (2018)
- Roberto Valle, Renzo Baccichetto, Sabrina Barro, Alessandro Calderan, Emanuele Carbonieri, Maura Chinellato, Mario Chiatto, Alessandra D’Eri, Francesco Corazza, Massimo D’Atri, Raffaela Drigo, Simeone Fabris, Giuseppe Fabris Gelli, Antonio Lo Giudice, Federica Noventa, Alessandro Pollon, Paolo Santin, Franco Zanardi, Loredano Milani, Heart failure in Eastern Veneto: prevalence, hospitalization rate, adherence to guidelines and social costs , Monaldi Archives for Chest Disease: Vol. 66 No. 1 (2006): Cardiac series
- Giovanni Pulignano, Maria Denitza Tinti, Donatella Del Sindaco, Stefano Tolone, Giovanni Minardi, Antonio Lax, Massimo Uguccioni, Barriers to cardiac rehabilitation access of older heart failure patients and strategies for better implementation , Monaldi Archives for Chest Disease: Vol. 84 No. 1-2 (2015): Cardiac series
- Enrico Vizzardi, Edoardo Sciatti, Ivano Bonadei, Natalia L. Pezzali, Carlo M. Lombardi, Marco Metra, Red cell distribution width and chronic heart failure: prognostic role beyond echocardiographic parameters , Monaldi Archives for Chest Disease: Vol. 84 No. 1-2 (2015): Cardiac series
- Daniela Miani, Dario Gregori, Marco Ghidina, Patrizia Rozbowsky, Laura Pilotto, Maria Cecilia Albanese, Claudio Fresco, Paolo Maria Fioretti, The Left Ventricular Dysfunction Questionnaire: Italian translation and validation , Monaldi Archives for Chest Disease: Vol. 64 No. 2 (2005): Cardiac series
- Mario Sorice, Francesco Paolo Tritto, Chiara Sordelli, Rosario Gregorio, Luigi Piazza, N-3 polyunsaturated fatty acids reduces post-operative atrial fibrillation incidence in patients undergoing “on-pump†coronary artery bypass graft surgery , Monaldi Archives for Chest Disease: Vol. 76 No. 2 (2011): Cardiac series
You may also start an advanced similarity search for this article.
