Thyroid Hormones and Cardiovascular Function and Diseases

In the paper

“The normal negative feedback regulation of thyroid function is disrupted by illness, including conditions such as acute myocardial infarction (AMI) or heart failure (HF), and is characterized by a reduction in serum TH without a concomitant rise in circulating TSH levels”

In the paper

“TH levels regulate TRH and TSH production and release (7).”

What the sources say

• Not checked yetcites [7] Larsen, 1982, Thyroid-pituitary interaction: feedback regulation of thyrotropin secretion by thyroid hormones, N Engl J Med source

In the paper

“Two subsequent trials suggested that the reduction of LDL-C was approximately 0.3 mmol/l (11.6 mg/dl) (16,41).”

What the sources say

• Not checked yetcites [16] Razvi, 2007, The beneficial effect of l-thyroxine on cardiovascular risk factors, endothelial function, and quality of life in subclinical hypothyroidism: randomized, crossover trial, J Clin Endocrinol Metab source
• Not checked yetcites [41] Iqbal, 2006, Serum lipid levels in relation to serum thyroid-stimulating hormone and the effect of thyroxine treatment on serum lipid levels in subjects with subclinical hypothyroidism: the Tromsø Study, J Intern Med source

In the paper

“Similar effects are observed when patients with chronic HF are treated with intravenous T 3 (18).”

What the sources say

• Not checked yetcites [18] Pingitore, 2008, Acute effects of triiodothyronine (T3) replacement therapy in patients with chronic heart failure and low-T3 syndrome: a randomized, placebo-controlled study, J Clin Endocrinol Metab source

In the paper

“is supported by the association of low serum T 3 levels with the presence of cardiac fibrosis in patients with idiopathic dilated cardiomyopathy (30).”

What the sources say

• Not checked yetcites [30] Wang, 2016, Free triiodothyronine level correlates with myocardial injury and prognosis in idiopathic dilated cardiomyopathy: evidence from cardiac MRI and SPECT/PET imaging, Sci Rep source

In the paper

“Thus, T 3 has the unique pharmacological properties of an inodilator acting primarily on diastolic dysfunction.”

In the paper

“Pulmonary artery hypertension that resolves after return to the euthyroid state has been reported in patients with thyrotoxicosis mainly due to a fall in cardiac output.”

In the paper

“Thus, serum TSH is a robust marker of systemic TH status.”

In the paper

“Thus, an association, if present, is likely to be weak, with SCH contributing to a small increase in serum LDL-C, ranging between 3 and 15 mg/dl (0.1 to 0.4 mmol/l) (42).”

What the sources say

• Not checked yetcites [42] Tanis, 1996, Effect of thyroid substitution on hypercholesterolaemia in patients with subclinical hypothyroidism: a reanalysis of intervention studies, Clin Endocrinol (Oxf) source

In the paper

“the antifibrotic effect of TH is also linked to the T 3 -induced inhibition of profibrotic pathways, (29)”

What the sources say

• Not checked yetcites [29] van Rooij, 2009, A family of microRNAs encoded by myosin genes governs myosin expression and muscle performance, Dev Cell source

In the paper

“The protein receptors bind T 3 with greater (>10Â) affinity than T 4 (8).”

What the sources say

• Not checked yetcites [8] Sandler, 2004, Thyroxine-thyroid hormone receptor interactions, J Biol Chem source

In the paper

“Minor changes in TH concentration may have an adverse impact on the CV system”

• Also stated in: § Abstract · plain

  “minor alterations in TH concentration can affect cardiovascular (CV) physiology”

In the paper

“Hypothyroidism is associated with a small but significant increase in lipid parameters (31), in particular, an elevation of low-density lipoproteins (LDLs) (32).”

What the sources say

• Not checked yetcites [31] Canaris, 2000, The Colorado thyroid disease prevalence study, Arch Intern Med source
• Not checked yetcites [32] Duntas, 2002, Thyroid disease and lipids, Thyroid source

In the paper

“The pulmonary vasculature is not as responsive to the vasodilatory effects TH as is the systemic vasculature (19).”

What the sources say

• Not checked yetcites [19] Marvisi, 2006, Pulmonary hypertension is frequent in hyperthyroidism and normalizes after therapy, Eur J Intern Med source

In the paper

“The relationship between subclinical hyperthyroidism (SHyper) and blood pressure is less clear, with most published studies showing no association (45)(46)(47).”

What the sources say

• Not checked yetcites (45)(46)(47)

In the paper

“The TRa1 isoform has been shown to play an important role in the regulation of cardiac genes (Figure 1).”

What the sources say

• Not checked yetcites (Figure 1)

In the paper

“TH on the activity of metalloproteinases and their inhibitors (28).”

What the sources say

• Not checked yetcites [28] Kinugawa, 2005, Thyroid hormone induces cardiac myocyte hypertrophy in a thyroid hormone receptor α1-specific manner that requires TAK1 and p38 mitogen-activated protein kinase, Mol Endocrinol source

In the paper

“subclinical thyroid dysfunction has been associated with a 20% to 80% increase in vascular morbidity and mortality risk (4)(5)(6)”

What the sources say

• Not checked yetcites (4)(5)(6)

In the paper

“In addition to the genomic effects of T 3 described previously, TH (both T 4 and T 3 ) exert nongenomic effects on the cardiac myocyte and, as discussed later, on the vasculature.”

In the paper

“Overt and SHyper have been associated with increased markers of thrombogenesis (fibrinogen and factor X levels) (58,59).”

What the sources say

• Not checked yetcites [58] Dörr, 2006, Low serum thyrotropin is associated with high plasma fibrinogen, J Clin Endocrinol Metab source
• Not checked yetcites [59] Erem, 2006, Blood coagulation, fibrinolytic activity and lipid profile in subclinical thyroid disease: subclinical hyperthyroidism increases plasma factor X activity, Clin Endocrinol (Oxf) source

In the paper

“The reduced interatrial action potential duration facilitates the occurrence of AF by enhancing the spreading of ectopic activity from the left atrium (76).”

What the sources say

• Not checked yetcites [76] Bielecka-Dabrowa, 2009, The mechanisms of atrial fibrillation in hyperthyroidism, Thyroid Res source

In the paper

“The onset of AF may increase CV morbidity and mortality, resulting from severe HF and stroke (75).”

What the sources say

• Not checked yetcites [75] Biondi, 2012, Mechanisms in endocrinology: heart failure and thyroid dysfunction, Eur J Endocrinol source

In the paper

“as does pulse wave velocity, a surrogate measure of arterial stiffness (52,53).”

What the sources say

• Not checked yetcites [52] Dernellis, 2002, Effects of thyroid replacement therapy on arterial blood pressure in patients with hypertension and hypothyroidism, Am Heart J source
• Not checked yetcites [53] Obuobie, 2002, Increased central arterial stiffness in hypothyroidism, J Clin Endocrinol Metab source

In the paper

“Similarly, a Danish population study did not find any link between the risk of stroke and overt, mild, and severe hyperthyroidism after stratifying the analysis according to TSH levels (74).”

What the sources say

• Not checked yetcites [74] Selmer, 2014, Subclinical and overt thyroid dysfunction and risk of all-cause mortality and cardiovascular events: a large population study, J Clin Endocrinol Metab source

In the paper

“However, despite the high cardiac output state, hyperthyroid patients have impaired cardiopulmonary function during effort, reflecting their reduced CV and respiratory reserve during exercise (70).”

What the sources say

• Not checked yetcites [70] Biondi, 2010, Cardiovascular involvement in patients with different causes of hyperthyroidism, Nat Rev Endocrinol source

In the paper

“Both hyperlipidemia and thyroid antibodies are thought to reduce expression of endothelial nitric oxide synthase, thereby impairing vasodilation (15).”

What the sources say

• Not checked yetcites [15] Taddei, 2003, Impaired endothelium-dependent vasodilatation in subclinical hypothyroidism: beneficial effect of levothyroxine therapy, J Clin Endocrinol Metab source

In the paper

“This heightened thrombogenic state may, in part, explain the higher CV risk seen in patients with SCH.”

In the paper

“This is further supported by a study that found lower global fibrinolytic activity, such as tissue plasminogen activator, in SCH patients than in euthyroid controls (68).”

What the sources say

• Not checked yetcites [68] Guldiken, 2005, Global fibrinolytic capacity in patients with subclinical hypothyroidism, Endocr J source

In the paper

“However, this relationship has not been confirmed in all studies (94,99,100).”

What the sources say

• Not checked yetcites [94] Boekholdt, 2010, Initial thyroid status and cardiovascular risk factors: the EPIC-Norfolk prospective population study, Clin Endocrinol (Oxf) source
• Not checked yetcites [99] Rodondi, 2005, Subclinical hypothyroidism and the risk of heart failure, other cardiovascular events, and death, Arch Intern Med source
• Not checked yetcites [100] Parle, 2001, Prediction of all-cause and cardiovascular mortality in elderly people from one low serum thyrotropin result: a 10-year cohort study, Lancet source

In the paper

“A study using the Badimon chamber, a surrogate ex vivo model of plaque rupture in a moderately stenosed coronary artery, showed increased thrombus in patients with SCH 7 to 10 days post-non-ST-segment elevation myocardial infarction compared with euthyroid patients, despite dual antiplatelet therapy (69)”

What the sources say

• Not checked yetcites [69] Viswanathan, 2014, Blood thrombogenicity is independently associated with serum TSH levels in post-non-ST elevation acute coronary syndrome, J Clin Endocrinol Metab source

In the paper

“One of the major factors that influences CV risk in SCH populations is age, and several observations have concluded that older individuals with SCH may have a lower risk of CV disease than younger ones (101).”

What the sources say

• Not checked yetcites [101] Kvetny, 2004, Subclinical hypothyroidism is associated with a low-grade inflammation, increased triglyceride levels and predicts cardiovascular disease in males below 50 years, Clin Endocrinol (Oxf) source

In the paper

“Thus, in the Rotterdam Study, aortic calcification and the prevalence of myocardial infarction was higher in patients with SCH who were positive for thyroid autoantibodies than in those with SCH alone (57).”

What the sources say

• Not checked yetcites [57] Hak, 2000, Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study, Ann Intern Med source

In the paper

“Untreated hyperthyroidism is associated with increased CV morbidity and mortality (73).”

What the sources say

• Not checked yetcites [73] Brandt, 2011, A critical review and meta-analysis of the association between overt hyperthyroidism and mortality, Eur J Endocrinol source

In the paper

“Hyperthyroidism is linked to increased supraventricular ectopic activity (76).”

What the sources say

• Not checked yetcites [76] Bielecka-Dabrowa, 2009, The mechanisms of atrial fibrillation in hyperthyroidism, Thyroid Res source

In the paper

“Interestingly, the risk of AF, sudden cardiac death, and reduced life expectancy have been noted to be related to higher free T 4 levels, even within the euthyroid range, in 1 prospective study of middle-aged and older people from Rotterdam (86).”

What the sources say

• Not checked yetcites [86] Bano, 2017, Association of thyroid function with life expectancy with and without cardiovascular disease: the Rotterdam Study, JAMA Intern Med source

In the paper

“Several factors could likely contribute to arterial stiffness and endothelial dysfunction in SCH and hypothyroidism, including hyperlipidemia and a proinflammatory state (54)(55)(56).”

What the sources say

• Not checked yetcites (54)(55)(56)

In the paper

“Severe hyperthyroidism may induce so-called high-output HF, even in patients without underlying heart disease.”

In the paper

“Moreover, grade 2 SHyper was associated with a higher risk of developing AF (HR: 2.54; 95% CI: 1.08 to 5.99) than grade 1 SHyper (HR: 1.63; 95% CI: 1.10 to 2.41) (85).”

What the sources say

• Not checked yetcites [85] Collet, 2012, Subclinical hyperthyroidism and the risk of coronary heart disease and mortality, Arch Intern Med source

In the paper

“This congestive circulation results from the increases in blood volume and heart rate, and the associated pulmonary arterial hypertension (Figure 4).”

What the sources say

• Not checked yetcites (Figure 4)

In the paper

“A number of observational studies of community-dwelling individuals have shown an increased risk for CV disease (56,(95)(96)(97).”

What the sources say

• Not checked yetcites (56,(95)(96)(97)

In the paper

“A metaanalysis of 6 studies did not find any evidence supporting an increased risk of stroke in participants with SHyper (87).”

What the sources say

• Not checked yetcites [87] Chaker, 2014, Subclinical thyroid dysfunction and the risk of stroke: a systematic review and meta-analysis, Eur J Epidemiol source

In the paper

“In addition, increased arterial stiffness and a low renin state are contributory factors leading to blood pressure and vascular dysregulation due to the lack of the normal vasodilatory effects of T 3 (4,43)”

What the sources say

• Not checked yetcites [4] Biondi, 2008, The clinical significance of subclinical thyroid dysfunction, Endocr Rev source
• Not checked yetcites [43] Danzi, 2003, Thyroid hormone and blood pressure regulation, Curr Hypertens Rep source

In the paper

“This discrepancy in results between the various cohorts is likely due to differences in the underlying populations studied and the study design.”

In the paper

“Experimental studies have shown that TH excess can provoke the occurrence of paroxysmal AF by increasing triggered activity in pulmonary veins (76)”

What the sources say

• Not checked yetcites [76] Bielecka-Dabrowa, 2009, The mechanisms of atrial fibrillation in hyperthyroidism, Thyroid Res source

In the paper

“The increase in rT 3 , the inactive TH metabolite, is a predictor of both short-and long-term mortality independent of other traditional parameters (120).”

What the sources say

• Not checked yetcites [120] Friberg, 2001, Association between increased levels of reverse triiodothyronine and mortality after acute myocardial infarction, Am J Med source

In the paper

“In addition, several studies of older patients have shown SCH to have either a protective or no impact on CV disease risk (103-105).”

What the sources say

• Not checked yetcites [103] Gussekloo, 2004, Thyroid status, disability and cognitive function, and survival in old age, JAMA source
• Not checked yetcites [104] Pearce, 2016, Serum thyroid function, mortality and disability in advanced old age: the Newcastle 85+ Study, J Clin Endocrinol Metab source
• Not checked yetcites [105] Cappola, 2006, Thyroid status, cardiovascular risk, and mortality in older adults, JAMA source

In the paper

“Furthermore, in addition to conventional risk factors, TH metabolism alterations have been associated with a worse prognosis in patients with both ischemic and nonischemic LV dysfunction in both acute decompensated and chronic stable HF (131-133).”

What the sources say

• Not checked yetcites [131] Chen, 2015, Free triiodothyronine levels and short-term prognosis in chronic heart failure patients with type 2 diabetes, Am J Med Sci source
• Not checked yetcites [132] Hayashi, 2016, Subclinical hypothyroidism is an independent predictor of adverse cardiovascular outcomes in patients with acute decompensated heart failure, ESC Heart Fail source
• Not checked yetcites [133] Rothberger, 2017, Usefulness of serum triiodothyronine (T3) to predict outcomes in patients hospitalized with acute heart failure, Am J Cardiol source

In the paper

“However, the overall results showed an improvement in CV performance, induced by both direct and indirect actions.”

In the paper

“A decrease in T 3 and increase in reverse T 3 (rT 3 ) are the most characteristic and persistent abnormalities of NTI.”

In the paper

“In the clinical setting, the most frequent alteration of TH metabolism is the low T 3 syndrome that occurs in 15% to 30% of patients with HF, with the incidence changing in relation to the clinical severity of the disease.”

What the sources say

• Not checked yetcites [129] Galli, 2010, The role of thyroid hormone in the pathophysiology of heart failure: clinical evidence, Heart Fail Rev source

In the paper

“In severely ill patients, T 4 levels drop as well.”

In the paper

“Similarly, in 501 patients with AMI (of whom 34% had low T 3 syndrome), the rate of major cardiac events at follow-up was higher in those with low free triiodothyronine (FT 3 ) levels than in those with preserved”

In the paper

“This structural likeness contributes, in part, to the effects of the drug on thyroid”

In the paper

“Trials of levothyroxine in SCH using surrogate markers have shown improvement in LV function, vascular endothelial function, atherogenic lipid particles, or cardiac mitochondrial function (4,91,105-108).”

What the sources say

• Not checked yetcites [4] Biondi, 2008, The clinical significance of subclinical thyroid dysfunction, Endocr Rev source
• Not checked yetcites [91] Biondi, 1999, Left ventricular diastolic dysfunction in patients with subclinical hypothyroidism, J Clin Endocrinol Metab source
• Not checked yetcites [105] Cappola, 2006, Thyroid status, cardiovascular risk, and mortality in older adults, JAMA source
• Not checked yetcites [106] Cooper, 2012, Subclinical thyroid disease, Lancet source
• Not checked yetcites [107] Monzani, 2001, Effect of levothyroxine on cardiac function and structure in subclinical hypothyroidism: a double blind, placebo-controlled study, J Clin Endocrinol Metab source
• Not checked yetcites [108] Ripoli, 2005, Does subclinical hypothyroidism affect cardiac pump performance? Evidence from a magnetic resonance imaging study, J Am Coll Cardio source

In the paper

“A number of experimental studies and observational clinical data in both hypo-and hyperthyroidism suggest that modulation of TH may be beneficial in reducing CV disease.”

In the paper

“Serum T 3 levels may be an independent predictor of LV dysfunction and New York Heart Association functional class (130).”

What the sources say

• Not checked yetcites [130] Pingitore, 2006, Early activation of an altered thyroid hormone profile in asymptomatic or mildly symptomatic idiopathic left ventricular dysfunction, J Card Fail source

In the paper

“T 3 mitochondrial protection is also exerted through other pathways, including mitochondrial adenosine triphosphatedependent potassium pathway, peroxisome proliferator-activated receptor gamma coactivator 1-alpha, and the mitochondrial transcription factor A (25).”

What the sources say

• Not checked yetcites [25] Forini, 2011, Early long-term L-T3 replacement rescues mitochondria and prevents ischemic cardiac remodelling in rats, J Cell Mol Med source

In the paper

“even subtle changes in thyroid function can lead to cardiac dysfunction”

In the paper

“Cardioprotection is an emerging target of therapeutic intervention in AMI to minimize irreversible ischemic damage and favor functional recovery of the ischemic-damaged myocardium (20).”

What the sources say

• Not checked yetcites [20] Pingitore, 2016, Cardioprotection and thyroid hormones, Heart Fail Rev source

In the paper

“The CV system is a major target of TH action”

In the paper

“Both low T 4 and T 3 levels, as well as high rT 3 levels are associated with a worse prognosis.”

In the paper

“In particular, patients with reduced LV ejection fraction and low T 3 have higher mortality than patients with similar LV ejection fractions, but normal T 3 (134).”

What the sources say

• Not checked yetcites [134] Pingitore, 2005, Triiodothyronine levels for risk stratification of patients with chronic heart failure, Am J Med source

In the paper

“there is increasing evidence that changes in TH levels in otherwise euthyroid patients with CV disease (such as AMI or HF) may be a marker of poor prognosis”

In the paper

“Although a reduction in oxygen consumption by lowering TH levels during acute ischemia could be considered beneficial, the net effect of lower TH levels in the heart may still be detrimental because of its important role in postischemic LV remodeling, maintaining CV function and mitochondrial integrity (6).”

What the sources say

• Not checked yetcites [6] Jabbar, 2017, Thyroid hormones and cardiovascular disease, Nat Rev Cardiol source

In the paper

“Although these changes may, in part, be due to the illness in general, animal studies provide convincing evidence for additional, specific down-regulation of local TH action in CV disease.”

In the paper

“This result was also confirmed in a large multicenter cohort of patients with ischemic and nonischemic HF with severe LV dysfunction (LV ejection fraction #35%), in which abnormal TH function was associated with significantly increased risk for death (135).”

What the sources say

• Not checked yetcites [135] Mitchell, 2013, Thyroid function in heart failure and impact on mortality, J Am Coll Cardiol HF

In the paper

“A few hours after the onset of acute illness, marked changes in serum TH levels occur.”

In the paper

“In the context of HF, THs have a cardioprotective role through multifaceted direct or indirect actions at the level of the myocytes, the interstitium, and the vasculature (Figure 2) (6).”

What the sources say

• Not checked yetcites [6] Jabbar, 2017, Thyroid hormones and cardiovascular disease, Nat Rev Cardiol source

In the paper

“T 3 treatment counteracts the decrease in miR-30a levels, thus limiting the activation of p53 and the cascade leading to mitochondrial injury and cell death in the AMI border zone (23).”

What the sources say

• Not checked yetcites [23] Forini, 2014, Triiodothyronine prevents cardiac ischemia/reperfusion mitochondrial impairment and cell loss by regulating miR30a/p53 axis, Endocrinology source

In the paper

“T 3 down-regulation is consistent with experimental data showing that changes in circulating TH parameters after AMI are a result of increased D3 activity and reduced D1 and D2 activity (115).”

What the sources say

• Not checked yetcites [115] Olivares, 2007, Thyroid function disturbance and type 3 iodothyronine deiodinase induction after myocardial infarction in rats a time course study, Endocrinology source

In the paper

“In another study of 457 AMI patients, thyroid dysfunction including SCH, SHyper, and low T 3 syndrome was associated with higher incidence of major cardiac events (112).”

What the sources say

• Not checked yetcites [112] Özcan, 2014, Sick euthyroid syndrome is associated with poor prognosis in patients with ST segment elevation myocardial infarction undergoing primary percutaneous intervention, Cardiol J source

In the paper

“TH treatment reduces interstitial fibrosis in animal models of ischemic and nonischemic HF”

In the paper

“Propranolol decreases circulating serum T 3 levels in a dose-dependent manner due to inhibition of the deiodinase enzymes (139).”

What the sources say

• Not checked yetcites [139] Wiersinga, 1991, Propranolol and thyroid hormone metabolism, Thyroid source

In the paper

“T 3 at 6 months was an independent predictor of LV ejection fraction changes between the early and follow-up periods (123).”

What the sources say

• Not checked yetcites [123] Lymvaios, 2011, Thyroid hormone and recovery of cardiac function in patients with acute myocardial infarction: a strong association?, Eur J Endocrinol source

In the paper

“Amiodarone-induced thyroid dysfunction occurs because of both its iodine content and its direct toxic effects on thyroid parenchyma.”

In the paper

“FT 3 was the most important predictor of subsequent cardiac events (119).”

What the sources say

• Not checked yetcites [119] Zhang, 2012, A low fT3 level as a prognostic marker in patients with acute myocardial infarctions, Intern Med source

In the paper

“excess increases cardiac output by affecting stroke volume and heart rate(6,71).”

What the sources say

• Not checked yetcites [6] Jabbar, 2017, Thyroid hormones and cardiovascular disease, Nat Rev Cardiol source
• Not checked yetcites [71] Klein, 2007, Thyroid disease and the heart, Circulation source

In the paper

“Patients with severe hyperthyroidism may have coronary vasospasm leading to chest pain at rest or myocardial ischemia(6,70,71,79).”

What the sources say

• Not checked yetcites [6] Jabbar, 2017, Thyroid hormones and cardiovascular disease, Nat Rev Cardiol source
• Not checked yetcites [70] Biondi, 2010, Cardiovascular involvement in patients with different causes of hyperthyroidism, Nat Rev Endocrinol source
• Not checked yetcites [71] Klein, 2007, Thyroid disease and the heart, Circulation source
• Not checked yetcites [79] Fazio, 2004, Effects of thyroid hormone on the cardiovascular system, Recent Prog Horm Res source

In the paper

“Mild and usually asymptomatic pulmonary arterial hypertension has been reported, especially in autoimmune hyperthyroidism, with an incidence ranging from 36% to 65% in echocardiographic studies(80).”

What the sources say

• Not checked yetcites [80] Siu, 2007, Hemodynamic changes in hyperthyroidism-related pulmonary hypertension: a prospective echocardiographic study, J Clin Endocrinol Metab source

In the paper

“Advanced age and the presence of associated CV risk factors (history of HF, hypertension, or diabetes mellitus, previous thromboembolism, left atrial enlargement, and LV dysfunction) can further elevate the embolic risk(70).”

What the sources say

• Not checked yetcites [70] Biondi, 2010, Cardiovascular involvement in patients with different causes of hyperthyroidism, Nat Rev Endocrinol source

In the paper

“studies in rats have shown that the acute decrease in serum T 4 and T 3 after AMI is mediated by the induction of D3 activity in the heart (115).”

What the sources say

• Not checked yetcites [115] Olivares, 2007, Thyroid function disturbance and type 3 iodothyronine deiodinase induction after myocardial infarction in rats a time course study, Endocrinology source

In the paper

“The main risk factors for the development of AF in hyperthyroid patients are increasing age, ischemic heart disease, congestive HF, or heart valve disease(77).”

What the sources say

• Not checked yetcites [77] Frost, 2004, Hyperthyroidism and risk of atrial fibrillation or flutter: a population-based study, Arch Intern Med source

In the paper

“This wide range reflects that a variety of factors can influence serum TSH levels such as age, sex, body mass index, race, smoking habits, iodine intake, time of sampling, concomitant medical conditions and treatments, plus the cutoff concentrations of serum TSH used to define the condition.”

In the paper

“review of published case reports in hyperthyroidism suggests a tendency toward increased overall thrombosis(61).”

What the sources say

• Not checked yetcites [61] Franchini, 2011, Hyperthyroidism and venous thrombosis: a casual or causal association? A systematic literature review, Clin Appl Thromb Hemost source

In the paper

“In SCH, factor VII activity and the factor VII activity-tofactor VII antigen ratio were significantly increased in women with SCH compared with controls(66).”

What the sources say

• Not checked yetcites [66] Müller, 2001, Haemostatic profile in hypothyroidism as potential risk factor for vascular or thrombotic disease, Eur J Clin Invest source

In the paper

“in patients with chronic HF, NTI has been associated with a worse prognosis (96,124,125).”

What the sources say

• Not checked yetcites [96] Iervasi, 2007, Association between increased mortality and mild thyroid dysfunction in cardiac patients, Arch Intern Med source
• Not checked yetcites [124] Iacoviello, 2008, Prognostic role of sub-clinical hypothyroidism in chronic heart failure outpatients, Curr Pharm Des source
• Not checked yetcites [125] Iervasi, 2003, Low-T3 syndrome: a strong prognostic predictor of death in patients with heart disease, Circulation source

In the paper

“considering the strong effects of disease in general on thyroid function, it is impossible to distinguish between cause and consequence in these clinical observational studies.”

In the paper

“The risk of ischemic stroke is enhanced by 44% in adults with hyperthyroidism compared with euthyroid controls(78).”

What the sources say

• Not checked yetcites [78] Sheu, 2010, Hyperthyroidism and risk of ischemic stroke in young adults: a 5-year follow-up study, Stroke source

In the paper

“most (at least 80%) patients with hypothyroidism have SCH (31).”

What the sources say

• Not checked yetcites [31] Canaris, 2000, The Colorado thyroid disease prevalence study, Arch Intern Med source

In the paper

“lower T 3 levels after AMI are an independent predictor of late recovery of LV function after 6 months (123).”

What the sources say

• Not checked yetcites [123] Lymvaios, 2011, Thyroid hormone and recovery of cardiac function in patients with acute myocardial infarction: a strong association?, Eur J Endocrinol source

In the paper

“The most frequent cardiac abnormality observed in SCH is diastolic dysfunction due to impaired ventricular filling and relaxation (90,91).”

What the sources say

• Not checked yetcites [90] Monzani, 2004, Effect of levothyroxine replacement on lipid profile and intima-media thickness in subclinical hypothyroidism: a double-blind, placebo- controlled study, J Clin Endocrinol Metab source
• Not checked yetcites [91] Biondi, 1999, Left ventricular diastolic dysfunction in patients with subclinical hypothyroidism, J Clin Endocrinol Metab source

In the paper

“However, pathophysiological and therapeutic relevance of the thyroid dysregulation after AMI are far from elucidated.”