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Cited by 135Thyroid Disorders and TreatmentsCardiomyopathy and Myosin StudiesHeart Failure Treatment and Management

Medium-term effectiveness of L-thyroxine treatment in idiopathic dilated cardiomyopathy

Moruzzi, Paolo, Doria, Elisabetta, Agostoni, Pier Giuseppe·1996·The American Journal of Medicine
DOI 10.1016/s0002-9343(96)00281-1
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Abstract

Background In dilated cardiomyopathy, short-term administration of L-thyroxine (100 micrograms/ day) improves cardiac and exercise performance without changing the heart's adrenergic sensitivity. The aim of this study was to test the medium-term (3 months) efficacy of L-thyroxine (10 patients) compared with placebo (10 patients) and to find out whether later effects are obtainable.Methods Echocardiographic parameters in the control state and during acute changes of left ventricular afterload, cardiopulmonary exercise test, and hemodynamic parameters, including cardiac beta 1 responses to dobutamine, were obtained before and at the end of treatment.Results Significant (P < 0.05) changes were observed only with the active drug. After L-thyroxine, patients did not show evidence of chemical hyperthyroidism, despite the increase in thyroxine and the reduction in thyroid-stimulating hormone plasma levels. Cardiac performance improved, as shown by the increase in the left ventricular ejection fraction and rightward shift of the slope of the relation left ventricular ejection fraction/end-systolic stress. Resting cardiac output increased, and the left ventricular diastolic dimensions and systemic vascular resistances decreased. The responses of cardiac output and heart rate to dobutamine infusion were also enhanced. Functional capacity markedly improved, together with an increase in peak exercise cardiac output.Conclusion L-thyroxine does not lose its beneficial effects on cardiac and exercise performance on medium-term administration and does not induce adverse effects. In addition to the short-term study, the left ventricular diastolic dimensions were decreased. An upregulation of beta 1 receptors might explain the cardiac response to dobutamine.

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  • A small RCT in patients with dilated cardiomyopathy showed beneficial effects of medium-term (3 months) levothyroxine treatment on cardiac performance.

    “A small RCT [85] in patients with dilated cardiomyopathy showed beneficial effects of medium-term (3 months) levothyroxine treatment on cardiac performance, whereas another RCT [86] showed that the TH analogue 3,5 di-iodothyropropionic acid improved some hemodynamic variables in heart failure.”

    From An update on non-thyroidal illness syndrome (2021) · cites this paper as [85]

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Authors
Moruzzi, P., Doria, E., & Agostoni, P. G.
Affiliations
University of Milan (IT)
Corresponding author
Moruzzi, Paolo
Venue
The American Journal of Medicine
Publisher
Elsevier BV
Published
1996-11
Volume
101
Issue
5
Pages
461-467
ISSN
0002-9343 (ISSN-L)
DOI
10.1016/s0002-9343(96)00281-1
OpenAlex
W2031434874
Cited by
135
References
30
Citations by year
2026: 1 · 2025: 1 · 2024: 1 · 2023: 5 · 2022: 2 · 2021: 6 · 2020: 9 · 2019: 6 · 2018: 2 · 2017: 5 · 2016: 6 · 2015: 3 · 2014: 10 · 2013: 6 · 2012: 3
FWCI
1.88
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • The American Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiomyopathy and Myosin Studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
Keywords
levothyroxine, idiopathic dilated cardiomyopathy, thyroid hormone replacement, left ventricular ejection fraction, exercise capacity, dobutamine response, left ventricular end-diastolic diameter, cardiac output, thyroid-stimulating hormone, hyperthyroidism
MeSH terms
Aged, Cardiomyopathy, Dilated, Echocardiography, Exercise Test, Female, Hemodynamics, Hormones, Humans, Male, Middle Aged, Oxygen Consumption, Thyroxine, Time Factors, Electrocardiography, Ambulatory, Treatment Outcome

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