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Choi Y, Jung SY, Park JM, Suh J, Shin EJ, Chae HW, Kim HS, Kwon A. Combination therapy of liothyronine and levothyroxine for hypothyroidism-induced dilated cardiomyopathy. Ann Pediatr Endocrinol Metab 2023; 28:144-148. [PMID: 35718890 PMCID: PMC10329947 DOI: 10.6065/apem.2142218.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/28/2021] [Accepted: 12/14/2021] [Indexed: 11/20/2022] Open
Abstract
Thyroid hormone plays a vital role in regulating human metabolism. They affect the functions of major organs, such as the brain, liver, skeletal muscle, and heart. Hypothyroidism can lead to dilated cardiomyopathy and decreased heart function. In this report, we describe a case of a teenage boy who developed dilated cardiomyopathy due to hypothyroidism and was considered to undergo heart transplantation. Levothyroxine monotherapy was initiated but produced no improvement. Thereafter, a combination therapy of liothyronine and levothyroxine was administered, and heart function was gradually restored; he recovered completely after 6 months. Cardiac myocytes respond more specifically to liothyronine than to levothyroxine. Therefore, we suggest that liothyronine and levothyroxine combination therapy should be considered rather than levothyroxine monotherapy for hypothyroidism accompanied by heart disease.
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Affiliation(s)
- Youngha Choi
- Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Se Yong Jung
- Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jung Min Park
- Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Junghwan Suh
- Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Jung Shin
- Department of Pediatrics, Inha University Hospital, Incheon, Korea
| | - Hyun Wook Chae
- Department of Pediatrics, Gangnam Severance Hospital, Yonsei University College of Medicine , Seoul, Korea
| | - Ho-Seong Kim
- Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Ahreum Kwon
- Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
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Baghcheghi Y, Beheshti F, Seyedi F, Hosseini M, Hedayati-Moghadam M. Thymoquinone improved redox homeostasis in the heart and aorta of hypothyroid rats. Clin Exp Hypertens 2022; 44:656-662. [PMID: 35942678 DOI: 10.1080/10641963.2022.2108046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Propylthiouracil (PTU) is a common drug that is used in medicine for treating hyperthyroidism. Furthermore, hypothyroidism can also be induced with PTU. Considering the antioxidant effects of thymoquinone (TMQ), this study was designed to find out whether TMQ could counteract the oxidative damage in the heart and aorta tissues induced by hypothyroidism in rats. METHODS Animals were arranged into four groups: (1) Control, (2) PTU, (3) PTU-TMQ 5, and (4) PTU-TMQ 10. Hypothyroidism was induced in rats by giving 0.05% PTU in drinking water. PTU and TMQ (5 and 10 mg/kg, ip) treatments were done for 42 days. Finally, the animals were sacrificed and the serum of the rats was collected for thyroxine level assessment. The heart and aorta tissues were also removed for biochemical oxidative stress markers measurement. RESULTS A lower serum thyroxine level was observed after PTU treatment compared to the control group. Hypothyroidism also was accompanied by a decrease of thiol content, and superoxide dismutase (SOD), and catalase (CAT) activities in the heart and aorta tissues while increased malondialdehyde (MDA). Furthermore, a significant reduction in oxidative damage was noted in the heart and aorta following the administration of TMQ (5 and 10 mg/kg) which was indicated by the reduction in MDA and improved activities of SOD, CAT, and thiol. CONCLUSION In this study, TMQ was found to improve oxidative damages in the heart and aorta tissues of hypothyroid rats.
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Affiliation(s)
- Yousef Baghcheghi
- Student Research Committee Jiroft University of Medical Sciences, Jiroft, Iran
| | - Farimah Beheshti
- Neuroscience Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,Department of Physiology, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Fatemeh Seyedi
- Student Research Committee Jiroft University of Medical Sciences, Jiroft, Iran.,Department of Anatomical Sciences, School of Medicine, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Mahmoud Hosseini
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdiyeh Hedayati-Moghadam
- Student Research Committee Jiroft University of Medical Sciences, Jiroft, Iran.,Department of Physiology, School of Medicine, Jiroft University of Medical Sciences, Jiroft, Iran
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Baghcheghi Y, Beheshti F, Hosseini M, Gowhari-Shabgah A, Ali-Hassanzadeh M, Hedayati-Moghadam M. Cardiovascular protective effects of PPARγ agonists in hypothyroid rats: protection against oxidative stress. Clin Exp Hypertens 2022; 44:539-547. [PMID: 35722928 DOI: 10.1080/10641963.2022.2079669] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Hypothyroidism disturbs redox homeostasis and takes part in cardiovascular system dysfunction. Considering antioxidant and cardio-protective effects of PPAR-γ agonists including pioglitazone (POG) and rosiglitazone (RSG), the present study was aimed to determine the effect of POG or RSG on oxidants and antioxidants indexes in the heart and aorta tissues of Propylthiouracil (PTU)-induced hypothyroid rats. MATERIALS AND METHODS The animals were divided into six groups: (1) Control; (2) propylthiouracil (PTU), (3) PTU-POG 10, (4) PTU-POG 20, (5) PTU-RSG 2, and (6) PTU-RSG 4. Hypothyroidism was induced in rats by giving 0.05% propylthiouracil (PTU) in drinking water for 42 days. The rats of PTU-POG 10 and PTU-POG 20 groups received 10 and 20 mg/kg POG, respectively, besides PTU, and the rats of PTU-RSG 2 and PTU-RSG 4 groups received 2 and 4 mg/kg RSG, respectively, besides PTU. The animals were sacrificed, and the serum of the rats was collected to measure thyroxine level. The heart and aorta tissues were also removed for the measurement of biochemical oxidative stress markers. RESULTS Hypothyroidism was induced by PTU administration, which was indicated by lower serum thyroxine levels. Hypothyroidism also was accompanied by a decrease of catalase (CAT), superoxide dismutase (SOD) activities, and thiol concentration in the heart and aorta tissues while increased level of malondialdehyde (MDA). Interestingly, administration of POG or RSG dramatically reduced oxidative damage in the heart and aorta, as reflected by a decrease in MDA and increased activities of SOD, CAT, and thiol content. CONCLUSION The results of this study showed that administration of POG or RSG decreased oxidative damage in the heart and aorta tissues induced by hypothyroidism in rats.
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Affiliation(s)
- Yousef Baghcheghi
- Student Research Committee Jiroft University of Medical Sciences, Jiroft, Iran
| | - Farimah Beheshti
- Neuroscience Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,Department of Physiology, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Mahmoud Hosseini
- Division of Neurocognitive Sciences, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mohammad Ali-Hassanzadeh
- Department of Immunology, School of Medicine, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Mahdiyeh Hedayati-Moghadam
- Student Research Committee Jiroft University of Medical Sciences, Jiroft, Iran.,Department of Physiology, School of Medicine, Jiroft University of Medical Sciences, Jiroft, Iran
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Thyroid Abnormalities in Heart Failure. Cardiol Clin 2022; 40:139-147. [DOI: 10.1016/j.ccl.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Abstract
The effects of hyperthyroidism and hypothyroidism on the heart and cardiovascular system are well documented. It has also been shown that various forms of heart disease including but not limited to congenital, hypertensive, ischemic, cardiac surgery, and heart transplantation cause an alteration in thyroid function tests including a decrease in serum liothyronine (T3). This article discusses the basic science and clinical data that support the hypothesis that these changes pose pathophysiologic and potential novel therapeutic challenges.
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Affiliation(s)
- Sara Danzi
- Department of Biological Sciences and Geology, Queensborough Community College, City University of New York, 222-05 56th Avenue, Bayside, NY 11364, USA
| | - Irwin Klein
- NYU School of Medicine, 555 Broadhollow Road, Suite 229, Melville, NY 11747, USA.
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Hedayati M, Niazmand S, Hosseini M, Baghcheghi Y, Beheshti F, Niazmand S. Vitamin E improved redox homeostasis in heart and aorta of hypothyroid rats. Endocr Regul 2017; 51:205-212. [PMID: 29232192 DOI: 10.1515/enr-2017-0021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVES The objective of this study was to evaluate the effect of vitamin E on the oxidative stress parameters and antioxidant defense enzymes in the heart and aorta of 6-n-propylthiouracil (PTU)-induced hypothyroid rats. METHODS The animals were divided into 4 experimental groups: Group 1 (Euthyroid) received tap water, Group 2 (Hypothyroid) received 0.05 % of PTU in dissolved in their drinking water, Group 3 (PTU+Vit E) hypothyroid rats treated with vitamin E, and Group 4 (Euthyroid+Vit E). Vitamin E was injected daily (20 mg/kg) to groups 3 and 4 via daily gavage for 6 weeks. Malondialdehyde (MDA) levels, total thiol levels, and the activities of Cu, Zn-superoxide dismutase (SOD) and catalase (CAT) were evaluated in the aortic and cardiac tissues. RESULTS A significant decrease of thyroxine (T4) serum levels confirmed hypothyroidism in rats, which received PTU. The MDA level increased and total thiol level decreased in the hypothyroid group compared to control group (p<0.001). Th e activities of SOD and CAT significantly decreased in the hypothyroid rats in comparison to the control. Vitamin E treatment resulted in increased levels of total thiol, SOD, and CAT within aortic and cardiac tissues and decreased levels of MDA in comparison with the hypothyroid group (p<0.01-p<0.001). CONCLUSIONS PTU-induced hypothyroidism resulted in oxidative stress. Chronic administration of vitamin E to hypothyroid rats decreased the oxidative stress markers in the aortic and cardiac tissues.
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Abstract
Thyroid hormones have an intimate relationship with cardiac function. Some of the most significant clinical signs and symptoms of thyroid disease are the cardiac manifestations. In both hypothyroidism and hyperthyroidism, the characteristic physiological effects of thyroid hormone can be understood from the actions at the molecular and cellular level. Here we explore topics from the metabolism and cellular effects of thyroid hormone to special considerations related to statin and amiodarone therapy for the alterations in thyroid hormone metabolism that accompany heart disease.
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Modulation by thyroid hormone of myosin light chain phosphorylation and aquaporin 5 protein expression in intact lung. J Physiol Biochem 2015; 71:99-106. [DOI: 10.1007/s13105-015-0386-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 01/21/2015] [Indexed: 10/24/2022]
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Abstract
Thyroid hormones, specifically triiodothyronine (T3), have significant effects on the heart and cardiovascular system. Hypothyroidism, hyperthyroidism, subclinical thyroid disease, and low T3 syndrome each cause cardiac and cardiovascular abnormalities through both genomic and nongenomic effects on cardiac myocytes and vascular smooth muscle cells. In compromised health, such as occurs in heart disease, alterations in thyroid hormone metabolism may further impair cardiac and cardiovascular function. Diagnosis and treatment of cardiac disease may benefit from including analysis of thyroid hormone status, including serum total T3 levels.
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Affiliation(s)
- Sara Danzi
- Department of Biological Sciences and Geology, Queensborough Community College, 222-05 56th Avenue, Bayside, NY 11364, USA.
| | - Irwin Klein
- Department of Medicine and Cell Biology, NYU School of Medicine, New York, NY 10016, USA; Private Office, 935 Northern Boulevard, Great Neck, NY 11021, USA
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Cerillo AG, Storti S, Kallushi E, Haxhiademi D, Miceli A, Murzi M, Berti S, Glauber M, Clerico A, Iervasi G. The low triiodothyronine syndrome: a strong predictor of low cardiac output and death in patients undergoing coronary artery bypass grafting. Ann Thorac Surg 2014; 97:2089-95. [PMID: 24636708 DOI: 10.1016/j.athoracsur.2014.01.049] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 01/04/2014] [Accepted: 01/14/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND There is strong clinical and experimental evidence that altered thyroid homeostasis negatively affects survival in cardiac patients, but a negative effect of the low triiodothyronine (T3) syndrome on the outcome of coronary artery bypass grafting (CABG) has not been demonstrated. This study was designed to evaluate the prognostic significance of low T3 syndrome in patients undergoing CABG. METHODS The thyroid profile was evaluated at hospital admission in 806 consecutive CABG patients. Known thyroid disease, severe systemic illness, and use of drugs interfering with thyroid metabolism were considered exclusion criteria. The effect of the baseline free T3 (fT3) concentration and of preoperative low T3 syndrome (fT3 <2.23 pmol/L) on the risk of low cardiac output (CO) and death was analyzed in a logistic regression model. RESULTS There were 19 (2.3%) deaths, and 64 (7.8%) patients experienced major complications. After univariate analysis, fT3, low T3, New York Heart Association class greater than II, low left ventricular ejection fraction (LVEF), and emergency were associated with low CO and hospital death. History of atrial fibrillation, cardiopulmonary bypass time, and peripheral vascular disease were associated only with low CO. At multivariate analysis, only fT3, low T3, emergency, and LVEF were associated with low CO, and fT3 (odds ratio, 0.172, 95% confidence interval, 0.078 to 0.379; p < 0.0001) and LVEF (odds ratio, 0.934, 95% confidence interval, 0.894 to 0.987; p = 0.03) were the only independent predictors of death. CONCLUSIONS Our study demonstrates that low T3 is a strong predictor of death and low CO in CABG patients. For this reason, the thyroid profile should be evaluated before CABG, and patients with low T3 should be considered at higher risk and treated accordingly.
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Affiliation(s)
- Alfredo Giuseppe Cerillo
- Operative Unit of Cardiac Surgery, "G. Pasquinucci" Hospital, "G. Monasterio" Foundation, Massa, Italy.
| | - Simona Storti
- Clinical Chemistry Laboratory, "G. Pasquinucci" Hospital, "G. Monasterio" Foundation, Massa, Italy
| | - Enkel Kallushi
- Operative Unit of Cardiac Surgery, "G. Pasquinucci" Hospital, "G. Monasterio" Foundation, Massa, Italy
| | - Dorela Haxhiademi
- Anesthesia and Intensive Care, "G. Pasquinucci" Hospital, "G. Monasterio" Foundation, Massa, Italy
| | - Antonio Miceli
- Operative Unit of Cardiac Surgery, "G. Pasquinucci" Hospital, "G. Monasterio" Foundation, Massa, Italy
| | - Michele Murzi
- Operative Unit of Cardiac Surgery, "G. Pasquinucci" Hospital, "G. Monasterio" Foundation, Massa, Italy
| | - Sergio Berti
- Cardiology, "G. Pasquinucci" Hospital, "G. Monasterio" Foundation, Massa, Italy
| | - Mattia Glauber
- Operative Unit of Cardiac Surgery, "G. Pasquinucci" Hospital, "G. Monasterio" Foundation, Massa, Italy
| | - Aldo Clerico
- Clinical Chemistry Laboratory, "G. Pasquinucci" Hospital, "G. Monasterio" Foundation, Massa, Italy
| | - Giorgio Iervasi
- Operative Unit of Cardiovascular Endocrinology and Metabolism, "G. Monasterio" Foundation, Istituto di Fisiologia Clinica del Consiglio Nazionale delle Ricerche, Pisa, Italy
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[Improvement in functional capacity after levothyroxine treatment in patients with chronic heart failure and subclinical hypothyroidism]. ACTA ACUST UNITED AC 2013; 60:427-32. [PMID: 23660007 DOI: 10.1016/j.endonu.2013.01.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 01/09/2013] [Accepted: 01/14/2013] [Indexed: 11/21/2022]
Abstract
AIM To assess whether levothyroxine treatment improves functional capacity in patients with chronic heart failure (New York Heart Association class i-iii) and subclinical hypothyroidism. METHODS One hundred and sixty-three outpatients with stable chronic heart failure followed up for at least 6 months were enrolled. A physical examination was performed, and laboratory tests including thyroid hormone levels, Doppler echocardiogram, radionuclide ventriculography, and Holter monitoring were requested. Functional capacity was assessed by of the 6-min walk test. Patients with subclinical hypothyroidism were detected and, after undergoing the s6-min walk test, were given replacement therapy. When they reached normal thyrotropin (TSH) levels, the 6-min walk test was performed again. The distance walked in both tests was recorded, and the difference in meters covered by each patient was analyzed. RESULTS Prevalence of subclinical hypothyroidism in patients with heart failure was 13%. These patients walked 292±63m while they were hypothyroid and 350±76m when TSH levels returned to normal, a difference of 58±11m (P<.011). Patients with normal baseline TSH levels showed no significant difference between the 2 6-min walk tests. CONCLUSIONS Patients with chronic heart failure and subclinical hypothyroidism significantly improved their physical performance when normal TSH levels were reached.
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von Saint Andre-von Arnim A, Farris R, Roberts JS, Yanay O, Brogan TV, Zimmerman JJ. Common endocrine issues in the pediatric intensive care unit. Crit Care Clin 2013; 29:335-58. [PMID: 23537679 DOI: 10.1016/j.ccc.2012.11.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Thyroid hormone is central to normal development and metabolism. Abnormalities in thyroid function in North America often arise from autoimmune diseases, but they rarely present as critical illness. Severe deficiency or excess of thyroid hormone both represent life-threatening disease, which must be treated expeditiously and thoroughly. Such deficiencies must be considered, because presentation may be nonspecific.
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Ziman ME, Bui HT, Smith CS, Tsukiji LA, Asmatey VM, Chu SB, Miano JS. The pharmacists' role in improving guideline compliance for thyroid function testing in patients with heart failure. J Pharm Pract 2011; 25:195-200. [PMID: 21844214 DOI: 10.1177/0897190011416008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This single-center retrospective pilot program's objective was to utilize outpatient pharmacists to improve laboratory test adherence in chronic heart failure (CHF) patients overdue for thyroid function testing, thereby demonstrating the value of the outpatient pharmacist and justifying possible clinical role expansion. Thyroid disorders may contribute to CHF development, progression, and exacerbation. Testing is the standard of care in CHF patients per American Heart Association's 2009 Guidelines. Delinquency was defined as labs not conducted within 1 year in patients with euthyroid history, within 6 months in patients with thyroid dysfunction, abnormal labs at any time without follow-up, or lab absence after thyroid medication initiation, adjustment, or discontinuation. Targeted 80 nonpregnant adult CHF patients with delinquent thyroid function tests were counseled to get thyroid labs at point of sale, via telephone, e-mail, or letter. In collaboration with physicians, pharmacists ordered thyroid-stimulating hormone (TSH) and free T4 (FT4) labs. For patients with abnormal laboratory results, pharmacists coordinated drug therapy and follow-up labs. Data were collected from November 1, 2009 to March 30, 2010. Seventy-two patients (90%) previously delinquent for thyroid function testing received relevant thyroid labs. Ten patients (12.5%) with abnormal thyroid function tests not on prior drug therapy received treatment.
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Affiliation(s)
- Melanie E Ziman
- Department of Pharmacy, Kaiser Permanente South Sacramento Medical Center, Sacramento, CA 95823, USA.
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Affiliation(s)
- Anthony Martin Gerdes
- Cardiovascular Health Research Center, Sanford Research/University of South Dakota, 1100 E 21st Street, Sioux Falls, SD 57105, USA.
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16
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Thyroid hormone in cardiac surgery. Vascul Pharmacol 2010; 52:131-7. [DOI: 10.1016/j.vph.2009.11.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Accepted: 11/23/2009] [Indexed: 11/22/2022]
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Henderson KK, Danzi S, Paul JT, Leya G, Klein I, Samarel AM. Physiological replacement of T3 improves left ventricular function in an animal model of myocardial infarction-induced congestive heart failure. Circ Heart Fail 2009; 2:243-52. [PMID: 19808346 DOI: 10.1161/circheartfailure.108.810747] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Patients with congestive heart failure (CHF) often have low serum triiodothyronine (T(3)) concentrations. In a rodent model of myocardial infarction-induced CHF and low serum T(3), we hypothesized that replacing T(3) to euthyroid levels would improve left ventricular function without producing untoward signs of thyrotoxicosis. METHODS AND RESULTS Adult male Sprague-Dawley rats were subjected to left anterior descending coronary artery ligation (myocardial infarction). One week post-myocardial infarction, left ventricular fractional shortening was significantly reduced to 22+/-1% in CHF animals versus 38+/-1% for sham-operated controls (P<0.001). Serum T(3) concentration was also significantly reduced (80+/-3 versus 103+/-6 ng/dL; P<0.001), in CHF animals versus Shams. At 9 weeks post-myocardial infarction, systolic function (+dP/dt max) was significantly attenuated in CHF animals (4773+/-259 versus 6310+/-267 mmHg/s; P<0.001) as well as diastolic function measured by half time to relaxation (15.9+/-1.2 versus 11.1+/-0.3 ms; P<0.001). alpha-myosin heavy chain expression was also significantly reduced by 77% (P<0.001), and beta-myosin heavy chain expression was increased by 21%. Continuous T(3) replacement was initiated 1 week post-myocardial infarction with osmotic mini-pumps (6 microg/kg/d), which returned serum T(3) concentrations to levels similar to Sham controls while resting conscious heart rate, arterial blood pressure and the incidence of arrhythmias were not different. At 9 weeks, systolic function was significantly improved by T(3) replacement (6279+/-347 mmHg/s; P<0.05) and a trend toward improved diastolic function (12.3+/-0.6 ms) was noted. T(3) replacement in CHF animals also significantly increased alpha- and reduced beta-MHC expression, (P<0.05). CONCLUSIONS These data indicate that T(3) replacement to euthyroid levels improves systolic function and tends to improve diastolic function, potentially through changes in myocardial gene expression.
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MESH Headings
- Animals
- Blood Pressure
- Diastole
- Disease Models, Animal
- Gene Expression Regulation
- Heart Failure/etiology
- Heart Failure/metabolism
- Heart Failure/physiopathology
- Heart Failure/therapy
- Heart Rate
- Hormone Replacement Therapy
- Hypertrophy, Left Ventricular/etiology
- Hypertrophy, Left Ventricular/physiopathology
- Hypertrophy, Left Ventricular/therapy
- Infusion Pumps, Implantable
- Male
- Myocardial Contraction
- Myocardial Infarction/complications
- Myocardial Infarction/metabolism
- Myocardial Infarction/physiopathology
- Myocardial Infarction/therapy
- Myosin Heavy Chains/genetics
- RNA, Messenger/metabolism
- Rats
- Rats, Sprague-Dawley
- Recovery of Function
- Systole
- Time Factors
- Triiodothyronine/administration & dosage
- Triiodothyronine/blood
- Ventricular Dysfunction, Left/etiology
- Ventricular Dysfunction, Left/metabolism
- Ventricular Dysfunction, Left/physiopathology
- Ventricular Dysfunction, Left/therapy
- Ventricular Myosins/genetics
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Affiliation(s)
- Kyle K Henderson
- Department of Medicine and the Cardiovascular Institute, Loyola University Medical Center, Maywood, Ill 60153, USA.
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The role of thyroid hormone in the pathophysiology of heart failure: clinical evidence. Heart Fail Rev 2008; 15:155-69. [DOI: 10.1007/s10741-008-9126-6] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2008] [Accepted: 11/06/2008] [Indexed: 11/26/2022]
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Abstract
The most recognizable features of hyperthyroidism are those that result from the effects of triiodothyronine (T3) on the heart and cardiovascular system: decreased systemic vascular resistance and increased resting heart rate, left ventricular contractility, blood volume, and cardiac output. Although these measures of cardiac performance are enhanced in hyperthyroidism, the finding of clinical cardiac failure can be somewhat paradoxical. About 6% of thyrotoxic individuals develop symptoms of heart failure, but less than 1% develop dilated -cardiomyopathy with impaired left ventricular systolic function. Heart failure resulting from thyrotoxicosis is due to a tachycardia-mediated mechanism leading to an increased level of cytosolic calcium during diastole with reduced ventricular contractility and diastolic dysfunction, often with tricuspid regurgitation. Pulmonary artery hypertension in thyrotoxicosis is gaining awareness as a cause of isolated right-sided heart failure. In both cases, older individuals are more likely to be affected. Treatment needs to be directed at management of the acute cardiovascular complications, control of the heart rate, and thyroid-specific therapy to restore a euthyroid state that will lead to resolution of the signs and symptoms of heart failure.
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François M, Delemer B. Quoi de neuf dans le couple thyroïde et cœur en 2008 ? ANNALES D'ENDOCRINOLOGIE 2008; 69 Suppl 1:S37-43. [DOI: 10.1016/s0003-4266(08)73967-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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