Thyroid hormones and cardiovascular disease.
Myocardial and vascular endothelial tissues have receptors for thyroid hormones and are sensitive to changes in the concentrations of circulating thyroid hormones. The importance of thyroid hormones in maintaining cardiovascular homeostasis can be deduced from clinical and experimental data showing that even subtle changes in thyroid hormone concentrations - such as those observed in subclinical hypothyroidism or hyperthyroidism, and low triiodothyronine syndrome - adversely influence the cardiovascular system. Some potential mechanisms linking the two conditions are dyslipidaemia, endothelial dysfunction, blood pressure changes, and direct effects of thyroid hormones on the myocardium. Several interventional trials showed that treatment of subclinical thyroid diseases improves cardiovascular risk factors, which implies potential benefits for reducing cardiovascular events. Over the past 2 decades, accumulating evidence supports the association between abnormal thyroid function at the time of an acute myocardial infarction (MI) and subsequent adverse cardiovascular outcomes. Furthermore, experimental studies showed that thyroid hormones can have an important therapeutic role in reducing infarct size and improving myocardial function after acute MI. In this Review, we summarize the literature on thyroid function in cardiovascular diseases, both as a risk factor as well as in the setting of cardiovascular diseases such as heart failure or acute MI, and outline the effect of thyroid hormone replacement therapy for reducing the risk of cardiovascular disease.
Institute of Genetic Medicine, Newcastle University, Central Parkway, Newcastle upon Tyne NE1 3BZ, UK.|Freeman Hospital, Freeman Rd, High Heaton, Newcastle upon Tyne NE7 7DN, UK.
Avais
A
Jabbar
Clinical Physiology Institute, CNR, Via Moruzzi 1, 56124, Pisa, Italy.
Alessandro
A
Pingitore
Institute of Genetic Medicine, Newcastle University, Central Parkway, Newcastle upon Tyne NE1 3BZ, UK.|Department of Endocrinology, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK.
Simon H S
SH
Pearce
Institute of Genetic Medicine, Newcastle University, Central Parkway, Newcastle upon Tyne NE1 3BZ, UK.|Freeman Hospital, Freeman Rd, High Heaton, Newcastle upon Tyne NE7 7DN, UK.
Azfar
A
Zaman
Clinical Physiology Institute, CNR, Via Moruzzi 1, 56124, Pisa, Italy.
Giorgio
G
Iervasi
Institute of Genetic Medicine, Newcastle University, Central Parkway, Newcastle upon Tyne NE1 3BZ, UK.|Gateshead Health NHS Foundation Trust, Saltwell Road South, Gateshead NE8 4YL, UK.
Salman
S
Razvi
D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control; D002319:Cardiovascular System / Q000503:physiopathology; D020249:Hormone Replacement Therapy / Q000379:methods; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications; D007037:Hypothyroidism / Q000150:complications; D013963:Thyroid Hormones / Q000502:physiology* / Q000627:therapeutic use
D013963:Thyroid Hormones