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Bogdan C, Ivan VM, Apostol A, Sandu OE, Maralescu FM, Lighezan DF. Hypothyroidism and Heart Rate Variability: Implications for Cardiac Autonomic Regulation. Diagnostics (Basel) 2024; 14:1261. [PMID: 38928676 PMCID: PMC11202468 DOI: 10.3390/diagnostics14121261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/10/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open
Abstract
Thyroid hormones have a pivotal role in controlling metabolic processes, cardiovascular function, and autonomic nervous system activity. Hypothyroidism, a prevalent endocrine illness marked by inadequate production of thyroid hormone, has been linked to different cardiovascular abnormalities, including alterations in heart rate variability (HRV). The study included 110 patients with hypothyroid disorder. Participants underwent clinical assessments, including thyroid function tests and HRV analysis. HRV, a measure of the variation in time intervals between heartbeats, serves as an indicator of autonomic nervous system activity and cardiovascular health. The HRV values were acquired using continuous 24-h electrocardiogram (ECG) monitoring in individuals with hypothyroidism, as well as after a treatment period of 3 months. All patients exhibited cardiovascular symptoms like palpitations or fatigue but showed no discernible cardiac pathology or other conditions associated with cardiac disease. The findings of our study demonstrate associations between hypothyroidism and alterations in heart rate variability (HRV) parameters. These results illustrate the possible influence of thyroid dysfunction on the regulation of cardiac autonomic function.
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Affiliation(s)
- Carina Bogdan
- Department VII, Internal Medicine II, Discipline of Cardiology, “Victor Babeş” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timişoara, Romania; (C.B.); (A.A.); (O.E.S.)
| | - Viviana Mihaela Ivan
- Department VII, Internal Medicine II, Discipline of Cardiology, “Victor Babeş” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timişoara, Romania; (C.B.); (A.A.); (O.E.S.)
- Centre for Molecular Research in Nephrology and Vascular Disease, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timișoara, Romania;
| | - Adrian Apostol
- Department VII, Internal Medicine II, Discipline of Cardiology, “Victor Babeş” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timişoara, Romania; (C.B.); (A.A.); (O.E.S.)
| | - Oana Elena Sandu
- Department VII, Internal Medicine II, Discipline of Cardiology, “Victor Babeş” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timişoara, Romania; (C.B.); (A.A.); (O.E.S.)
| | - Felix-Mihai Maralescu
- Centre for Molecular Research in Nephrology and Vascular Disease, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timișoara, Romania;
- Department of Internal Medicine II, Discipline of Nephrology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Daniel Florin Lighezan
- Department V, Internal Medicine I, Discipline of Medical Semiology I, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania;
- Center of Advanced Research in Cardiology and Hemostaseology, “Victor Babeș” University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timișoara, Romania
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Yang Y, Xue C, Zhao J, Zhang L, Wang Y, Ouyang M, Li J, Wang H, Wang C. Changes of cardiac function: cardiac adaptation in patients with hypothyroidism assessed by cardiac magnetic resonance-a meta-analysis. Front Endocrinol (Lausanne) 2024; 15:1334684. [PMID: 38919487 PMCID: PMC11196803 DOI: 10.3389/fendo.2024.1334684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 05/15/2024] [Indexed: 06/27/2024] Open
Abstract
Objective The meta-analysis aimed to explore the cardiac adaptation in hypothyroidism patients by cardiac magnetic resonance. Research methods and procedures Databases including PubMed, Cochrane Library, Embase, CNKI, and Sinomed for clinical studies of hypothyroidism on cardiac function changes. Databases were searched from the earliest data to 15 June 2023. Two authors retrieved studies and evaluated their quality. Review Manager 5.4.1 and Stata18 were used to analyze the data. This study is registered with the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY), 202440114. Results Six studies were selected for further analysis. Five of them reported differences in cardiac function measures between patients with hypothyroidism and healthy controls, and three studies reported cardiac function parameters after treatment in patients with hypothyroidism. The fixed-effect model combined WMD values for left ventricular ejection fraction (LVEF) had a pooled effect size of -1.98 (95% CI -3.50 to -0.44], P=0.01), implying that LVEF was lower in patients with hypothyroidism than in healthy people. Analysis of heterogeneity found moderate heterogeneity (P = 0.08, I² = 50%). WMD values for stroke volume (SV), cardiac index (CI), left ventricular end-diastolic volume index(LVEDVI), left ventricular end-systolic volume (LESVI), and left ventricular mass index(LVMI) were also analyzed, and pooled effect sizes showed the CI and LVEDVI of patients with hypothyroidism ware significantly decrease (WMD=-0.47, 95% CI [-0.93 to -0.00], P=0.05, WMD=-7.99, 95%CI [-14.01 to -1.96], P=0.009, respectively). Patients with hypothyroidism tended to recover cardiac function after treatment [LVEF (WMD = 6.37, 95%CI [2.05, 10.69], P=0.004), SV (WMD = 7.67, 95%CI [1.61, 13.74], P=0.01), CI (WMD = 0.40, 95%CI [0.01, 0.79], P=0.05)], and there was no difference from the healthy controls. Conclusion Hypothyroidism could affect cardiac function, although this does not cause significant heart failure. It may be an adaptation of the heart to the hypothyroid state. There was a risk that this adaptation may turn into myocardial damage. Cardiac function could be restored after treatment in patients with hypothyroidism. Aggressive levothyroxine replacement therapy should be used to reverse cardiac function. Systematic review registration https://inplasy.com, identifier (INPLASY202440114).
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Affiliation(s)
- Yucheng Yang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ji’nan, China
| | - Chen Xue
- School of Medical Imaging, Binzhou Medical University, Binzhou, China
| | - Junyu Zhao
- Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Laozhui Zhang
- Department of Endocrinology, The Second People’s Hospital Of Dongying, Dongying, China
| | - Yanwei Wang
- Department of Radiology, Shandong Provincial Hospital, Shandong University, Ji’nan, China
| | - Meixiang Ouyang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ji’nan, China
| | - Ju Li
- School of Medical Imaging, Binzhou Medical University, Binzhou, China
| | - Haipeng Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ji’nan, China
| | - Cuiyan Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ji’nan, China
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Krzeczkowski JE, Hall M, Saint-Amour D, Oulhote Y, McGuckin T, Goodman CV, Green R, Muckle G, Lanphear B, Till C. Prenatal fluoride exposure, offspring visual acuity and autonomic nervous system function in 6-month-old infants. ENVIRONMENT INTERNATIONAL 2024; 183:108336. [PMID: 38064923 PMCID: PMC10981044 DOI: 10.1016/j.envint.2023.108336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 11/10/2023] [Accepted: 11/17/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Prenatal fluoride exposure can have adverse effects on children's development; however, associations with visual and cardiac autonomic nervous system functioning are unknown. We examined associations between prenatal fluoride exposure and visual acuity and heart rate variability (HRV) in 6-month-old infants. METHODS We used data from Canadian mother-infant pairs participating in the Maternal-Infant Research on Environmental Chemicals (MIREC) cohort. We estimated prenatal fluoride exposure using: i) fluoride concentration in drinking water (mg/L), ii) maternal urinary fluoride adjusted for specific gravity (MUFSG; mg/L) and averaged across pregnancy, and iii) maternal fluoride intake (µg/kg/day) from consumption of water, tea, and coffee, adjusted for maternal body weight (kg). We used multivariable linear regression to examine associations between each measure of fluoride exposure and Teller Acuity Card visual acuity scores (n = 435) and assessed HRV (n = 400) using two measures: root mean square of successive differences (RMSSD) and the standard deviation of N-N intervals (SDNN) measured at 6-months of age. RESULTS Median (IQR) values for water fluoride, MUFSG, and daily fluoride intake were 0.20 (IQR: 0.13-0.56) mg/L; 0.44 (0.28-0.70) mg/L and 4.82 (2.58-10.83) µg/kg/day, respectively. After adjustment for confounding variables, water fluoride concentration was associated with poorer infant visual acuity (B = -1.51; 95 % CI: -2.14,-0.88) and HRV as indicated by lower RMSSD (B = -1.60; 95 % CI: -2.74,-0.46) but not SDNN. Maternal fluoride intake was also associated with poorer visual acuity (B = -0.82; 95 % CI: -1.35,-0.29) and lower RMSSD (B = -1.22; 95 % CI: -2.15,-0.30). No significant associations were observed between MUFSG and visual acuity or HRV. CONCLUSION Fluoride in drinking water was associated with reduced visual acuity and alterations in cardiac autonomic function in infancy, adding to the growing body of evidence suggesting fluoride's developmental neurotoxicity.
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Affiliation(s)
- John E Krzeczkowski
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada.
| | - Meaghan Hall
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Dave Saint-Amour
- Faculté de médecine - Département d'ophtalmologie, Université de Montréal, Montréal, Québec, Canada
| | - Youssef Oulhote
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sina, New York, NY, USA
| | - Taylor McGuckin
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Carly V Goodman
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Rivka Green
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Gina Muckle
- Centre de recherche du CHU de Québec-Université Laval, Québec, Canada; École de Psychologie, Université Laval, Québec, Québec, Canada
| | - Bruce Lanphear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Christine Till
- Department of Psychology, York University, Toronto, Ontario, Canada
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Sriraam N, Srinivasulu A, Prakash VS. Wireless CardioS framework for continuous ECG acquisition. J Med Eng Technol 2023; 47:201-216. [PMID: 37910047 DOI: 10.1080/03091902.2023.2267116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 09/30/2023] [Indexed: 11/03/2023]
Abstract
A first-level textile-based electrocardiogram (ECG) monitoring system referred to as "CardioS" (cardiac sensor) for continuous health monitoring applications is proposed in this study to address the demand for resource-constrained environments. and the signal quality assessment of a wireless CardioS was studied. The CardioS consists of a Lead-I ECG signal recorded wirelessly using silver-plated nylon woven (Ag-NyW) dry textile electrodes to compare the results of wired wearable Ag-NyW textile electrode-based ECG acquisition system and CardioS. The effect of prolonged usage of Ag-NyW dry electrodes on electrode impedance was tested in the current work. In addition, electrode half-cell potential was measured to validate the range of Ag-NyW dry electrodes for ECG signal acquisition. Further, the quality of signals recorded by the proposed wireless CardioS framework was evaluated and compared with clinical disposable (Ag-AgCl Gel) electrodes. The signal quality was assessed in terms of mean magnitude coherence spectra, signal cross-correlation, signal-to-noise-band ratio (Sband/Nband), crest factor, low and high band powers and power spectral density. The experimental results showed that the impedance was increased by 2.5-54.6% after six weeks of continuous usage. This increased impedance was less than 1 MΩ/cm2, as reported in the literature. The half-cell potential of the Ag-NyW textile electrode obtained was 80 mV, sufficient to acquire the ECG signal from the human body. All the fidelity parameters measured by Ag-NyW textile electrodes were correlated with standard disposable electrodes. The cardiologists validated all the measurements and confirmed that the proposed framework exhibited good performance for ECG signal acquisition from the five healthy subjects. As a result of its low-cost architecture, the proposed CardioS framework can be used in resource-constrained environments for ECG monitoring.
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Affiliation(s)
- N Sriraam
- Center for Medical Electronics and Computing, MS Ramaiah Institute of Technology, Bangalore, India
- Department of Medical Electronics Engineering, MS Ramaiah Institute of Technology, Bangalore, India
| | | | - V S Prakash
- Department of Cardiology, M.S. Ramaiah Medical College and Hospitals, Bangalore, India
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Byeon H, Moon Y, Lee S, Son GI, Lee E. Effect of the Marine Exercise Retreat Program on Thyroid-Related Hormones in Middle-Aged Euthyroid Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1542. [PMID: 36674297 PMCID: PMC9863542 DOI: 10.3390/ijerph20021542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
This study aimed to investigate the effects of a marine exercise retreat program on thyroid-related hormone levels. A total of 62 middle-aged euthyroid women participated in a 6-day marine exercise retreat program. Using thyroid-stimulating hormone (TSH) and free thyroxine (fT4) hormone levels, the participants were divided into high and low-hormone-level groups. Despite decreased TSH and fT4 levels after the program, the factors influencing changes in each group were different. TSH levels were influenced by changes in the normalized low frequency (nLF) of heart rate variability and carbon monoxide (CO) from all the participants, and changes in body fat percentage, nLF, and nitrogen dioxide (NO2) exposure level in the high TSH group. fT4 levels were influenced by changes in body mass index (BMI), NO2 exposure, and particulate matter diameter of 10 µm or less (PM10) exposure in all participants. Changes in BMI and CO exposure influenced the low fT4 group. Lastly, changes in the exercise stress test affected the high fT4 group. Thus, the marine exercise retreat program affected euthyroid thyroid-related hormone levels, and influencing factors differ depending on the initial value of the hormone.
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Affiliation(s)
- Hangjin Byeon
- Department of Public Health, College of Medicine, Korea University, Seoul 02841, Republic of Korea
| | - Yesol Moon
- Department of Biomedical Science, Graduate School, Korea University, Seoul 02841, Republic of Korea
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul 02841, Republic of Korea
| | - Seoeun Lee
- Department of Biomedical Science, Graduate School, Korea University, Seoul 02841, Republic of Korea
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul 02841, Republic of Korea
| | - Gwang-Ic Son
- Department of Biomedical Science, Graduate School, Korea University, Seoul 02841, Republic of Korea
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul 02841, Republic of Korea
| | - Eunil Lee
- Department of Public Health, College of Medicine, Korea University, Seoul 02841, Republic of Korea
- Department of Biomedical Science, Graduate School, Korea University, Seoul 02841, Republic of Korea
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul 02841, Republic of Korea
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