title: Thyroid hormone and heart failure.
abstract: Thyroid hormone metabolic disarray has been identified as a risk factor for the progression of heart disease and the development of heart failure (HF). Both hyper- and hypothyroidism have been associated with a failing myocardium. Poor cardiac contractility and low cardiac output due to hyperthyroidism is a rare occurrence and is mostly seen in patients with preexisting heart disease. Referred to as a "rate related" phenomenon, hyperthyroid-induced sustained sinus tachycardia or atrial fibrillation may further reduce ventricular contractility. Increasingly, the hypothyroid state, and in particular a low triiodothyronine level, has been associated with a reduced cardiac performance and poor prognosis in HF, even in the presence of normal thyroid-stimulating hormone levels. Low thyroid hormone levels alter cardiac gene expression and increase systemic vascular resistance, both resulting in a reduction of cardiac contractility and cardiac output. This review summarizes current data on thyroid dysfunction and HF as well as the emerging implications of the "low triiodothyronine state."
authors.affiliation: Department of Medicine, Division of Cardiology, Columbia University College of Physicians and Surgeons, 630 West 168th Street, New York, NY 10032, USA.
authors.forename: Ursula Maria
authors.initials: UM
authors.lastname: Schmidt-Ott
authors.forename: Deborah Davis
authors.initials: DD
authors.lastname: Ascheim
mesh_terms: D000638:Amiodarone / Q000009:adverse effects; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects; D006333:Heart Failure / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D013959:Thyroid Diseases / Q000503:physiopathology*; D013974:Thyroxine / Q000502:physiology*; D014284:Triiodothyronine / Q000172:deficiency / Q000502:physiology*
chemical_list: D000889:Anti-Arrhythmia Agents; D014284:Triiodothyronine; D000638:Amiodarone; D013974:Thyroxine