title: Mechanisms in endocrinology: Heart failure and thyroid dysfunction.
abstract: BACKGROUND
  Heart failure (HF) is a major cause of morbidity and mortality in Europe and in the United States. The aim of this review article was to assess the results of the prospective studies that evaluated the risk of HF in patients with overt and subclinical thyroid disease and discuss the mechanism of this dysfunction.
  
  
  METHODS
  Reports published with the following search terms were searched:, thyroid, hypothyroidism, hyperthyroidism, subclinical hyperthyroidism, subclinical hypothyroidism, levothyroxine, triiodothyronine, antithyroid drugs, radioiodine, deiodinases, clinical symptoms, heart rate, HF, systolic function, diastolic function, systemic vascular resistance, endothelial function, amiodarone and atrial fibrillation. The investigation was restricted to reports published in English.
  
  
  RESULTS
  The outcome of this analysis suggests that patients with untreated overt thyroid dysfunction are at increased risk of HF. Moreover, persistent subclinical thyroid dysfunction is associated with the development of HF in patients with serum TSH <0.1 or > 10 mU/l.
  
  
  CONCLUSIONS
  The timely recognition and effective treatment of cardiac symptoms in patients with thyroid dysfunction is mandatory because the prognosis of HF may be improved with the appropriate treatment of thyroid dysfunction.
authors.affiliation: Department of Clinical and Molecular Endocrinology and Oncology, University of Naples Federico II, Italy. bebiondi@unina.it
authors.forename: Bernadette
authors.initials: B
authors.lastname: Biondi
mesh_terms: D000638:Amiodarone / Q000008:administration & dosage / Q000009:adverse effects; D000818:Animals; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D001282:Atrial Flutter / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D003327:Coronary Disease / Q000209:etiology / Q000503:physiopathology; D018450:Disease Progression; D019317:Evidence-Based Medicine; D006333:Heart Failure / Q000097:blood / Q000139:chemically induced / Q000209:etiology* / Q000503:physiopathology* / Q000517:prevention & control; D006339:Heart Rate; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D007037:Hypothyroidism / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D017410:Practice Guidelines as Topic; D011379:Prognosis; D013318:Stroke Volume; D013959:Thyroid Diseases / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology*; D013963:Thyroid Hormones / Q000097:blood / Q000378:metabolism*; D013972:Thyrotropin / Q000097:blood*; D013974:Thyroxine / Q000378:metabolism; D014284:Triiodothyronine / Q000378:metabolism
chemical_list: D000889:Anti-Arrhythmia Agents; D013963:Thyroid Hormones; D014284:Triiodothyronine; D013972:Thyrotropin; D000638:Amiodarone; D013974:Thyroxine