N-terminal-pro-B-type natriuretic peptide in acute hyperthyroidism.
OBJECTIVE
Serum N-terminal-pro-B-type natriuretic peptide (NT-proBNP) is elevated in systolic heart failure due to volume expansion and pressure overload. Recent data suggest a direct stimulatory effect of thyroid hormones on NT-proBNP synthesis. We examined the influence of acutely induced hyperthyroidism on serum levels of NT-proBNP.


METHODS
Forty-three healthy women were evaluated before and after treatment with 60 mug triiodothyronine (T(3)) daily for 7 days in a noncontrolled study.


RESULTS
Before treatment, NT-proBNP was independently and inversely associated with thyrotropin (TSH), (r = -0.34, p = 0.02). T(3) therapy induced an increase in free T(3) (3.3 times, p < 0.0001) and suppression of TSH ( p < 0.0001). Heart rate increased by 14% ( p < 0.0001); weight decreased 0.6 kg ( p < 0.0001). Median NT-proBNP increased from 53 to 66 pg/mL ( p < 0.0001). The increase in NT-proBNP levels was independently associated with increase in free T(3) ( p = 0.05) and with reduction in TSH ( p = 0.04), without any association to the changes in cardiac workload.


CONCLUSIONS
NT-proBNP is influenced by thyroid function among healthy women, as demonstrated by an inverse association between TSH and NT-proBNP. Induction of an acute hyperthyroid state resulted in an increase in NT-proBNP, which seems to reflect a direct action of T(3) on the NT-proBNP secretion rather than an effect of increased cardiac workload.
Schultz
Marianne
M
Department of Cardiology and Endocrinology E, Frederiksberg University Hospital, Frederiksberg, Denmark. Marianne.Schultz@frh.regionh.dk
Kistorp
Caroline
C
Langdahl
Bente
B
Raymond
Ilan
I
Hildebrandt
Per
P
Faber
Jens
J
D000208:Acute Disease; D000368:Aged; D005260:Female; D006801:Humans; D006980:Hyperthyroidism / Q000378:metabolism*; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000737:chemistry* / Q000502:physiology; D010455:Peptides / Q000737:chemistry; D012044:Regression Analysis; D013960:Thyroid Function Tests; D013972:Thyrotropin / Q000378:metabolism; D013997:Time Factors; D016896:Treatment Outcome; D014284:Triiodothyronine / Q000627:therapeutic use*
D010455:Peptides; D014284:Triiodothyronine; D020097:Natriuretic Peptide, Brain; D013972:Thyrotropin