Thyroid Hormone Substitution Therapy Rapidly Enhances Left-Ventricular Diastolic Function in Hypothyroid Patients
Abstract
Objective: Alterations in thyroid status may lead to changes in both systolic and diastolic function of the heart. Pulsed Doppler echocardiography is a reliable non-invasive means of assessing left-ventricular (LV) diastolic function. The aim of the present study was to evaluate LV diastolic function in patients with primary hypothyroidism receiving thyroxine therapy. Methods: Twelve patients (all females, mean age 47 ± 17, range 16–69 years) with primary hypothyroidism were studied by pulsed Doppler echocardiography. The first examination was made before the start of thyroxine substitution and the second at 37–68 (mean 53 ± 10) days after commencing thyroxine treatment (mean dose 136 ± 22 µg/day). Results: During thyroxine substitution therapy, the hypothyroid patients became clinically euthyroid and serum T4 increased from 51 ± 21 to 119 ± 24 nmol/l; TSH decreased from 50.4 ± 55.3 to 1.2 ± 1.5 mU/l. During therapy, heart rate increased from 61 ± 8 to 68 ± 10 (p = 0.05). The LV posterior wall (7.8 ± 1.0 mm) and interventricular septum thickness (8.0 ± 1.4 mm) were significantly greater in hypothyroid patients than in the control subjects (6.4 ± 1.0 mm, p = 0.007 and 6.8 ± 1.0 mm, p = 0.04, respectively). There was no significant change in LV dimensions and wall thickness during follow-up. E/A max increased significantly during treatment (from 1.679 ± 0.432 to 1.947 ± 0.335, p = 0.006). The isovolumic relaxation time shortened significantly (from 88 ± 23 ms to 75 ± 24 ms, p = 0.005). Conclusions: The present study shows that LV diastolic function as assessed by pulsed Doppler echocardiography in hypothyroid patients is enhanced by thyroxine therapy during a rather short follow-up period.
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RCTs have demonstrated that LT4 replacement therapy affects myocardial function, particularly diastolic function, and over time the brachial artery intimal thickness.
“Similarly, RCTs have demonstrated that LT4 replacement therapy affects myocardial function (87) and particularly diastolic function (88-92), and, over time, the brachial artery intimal thickness (89,93).”
From Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement (2014) · cites this paper as [90]
Cites
STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT
Martin Bland, J., & Altman, D. (1986) · The Lancet · doi:10.1016/s0140-6736(86)90837-8 · Cited by 47,965 · see citing works
Henry, W. L., DeMaria, A. N., Gramiak, R., King, D. L., KISSLO, J. A., Popp, R. L., Sahn, D. J., Schiller, N. B., Tajik, A. J., Teichholz, L. E., et al. (1980) · Circulation · doi:10.1161/01.cir.62.2.212 · Cited by 934 · see citing works
Polikar, R., Burger, A. G., Scherrer, U., & Nicod, P. (1993) · Circulation · doi:10.1161/01.cir.87.5.1435 · Cited by 475 · see citing works
Thyroid hormone and the cardiovascular system
Klein, I. (1990) · The American Journal of Medicine · doi:10.1016/0002-9343(90)90531-h · Cited by 370 · see citing works
Stoddard, M. F., Pearson, A. C., Kern, M. J., Ratcliff, J., Mrosek, D. G., & Labovitz, A. J. (1989) · Circulation · doi:10.1161/01.cir.79.6.1226 · Cited by 351 · see citing works
Biochemical basis of thyroid hormone action in the heart.
Dillmann, W. H. (1990) · The American Journal of Medicine · doi:10.1016/0002-9343(90)90530-q · Cited by 338 · see citing works
Benjamin, E. J., Levy, D. A., Anderson, K. M., Wolf, P. A., Plehn, J. F., Evans, J. C., Comai, K., Fuller, D. L., & Sutton, M. S. J. (1992) · The American Journal of Cardiology · doi:10.1016/0002-9149(92)91199-e · Cited by 315 · see citing works
Labovitz, A. J., & Pearson, A. C. (1987) · American Heart Journal · doi:10.1016/0002-8703(87)90795-2 · Cited by 284 · see citing works
Influence of aging on Doppler echocardiographic indices of left ventricular diastolic function.
Spirito, P., & Maron, B. J. (1988) · Heart · doi:10.1136/hrt.59.6.672 · Cited by 216 · see citing works
Fazio, S., Biondi, B., Carella, C., Sabatini, D., Cittadini, A., Panza, N., Lombardi, G., & Saccà, L. (1995) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.80.7.7608283 · Cited by 119 · see citing works
Recognition and management of cardiovascular disease related to thyroid dysfunction
Ladenson, P. W. (1990) · The American Journal of Medicine · doi:10.1016/0002-9343(90)90532-i · Cited by 111 · see citing works
Arem, R., Rokey, R., Kiefe, C. I., Escalante, D. A., & Rodríguez, A. (1996) · Thyroid · doi:10.1089/thy.1996.6.397 · Cited by 88 · see citing works
Sodium Iodide Symporter in Health and Disease
Shen, D. H.-Y., Kloos, R. T., Mazzaferri, E. L., & Jhiang, S. M. (2001) · Thyroid · doi:10.1089/105072501300176372 · Cited by 87 · see citing works
Galderisi, M., Benjamin, E. J., Evans, J. C., D’Agostino, R. B., Fuller, D. L., Lehman, B., & Levy, D. A. (1993) · The American Journal of Cardiology · doi:10.1016/0002-9149(93)90991-k · Cited by 69 · see citing works
Galderisi, M., Benjamin, E. J., Evans, J. C., D’Agostino, R. B., Fuller, D. L., Lehman, B., Wolf, P. A., & Levy, D. A. (1992) · The American Journal of Cardiology · doi:10.1016/0002-9149(92)90772-q · Cited by 67 · see citing works
Reversible Abnormalities of Myocardial Relaxation in Hypothyroidism
Vora, J. P., O'Malley, B. P., Petersen, S. A., McCullough, A., Rosenthal, F. D., & Barnett, D. B. (1985) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-61-2-269 · Cited by 55 · see citing works
Spirito, P., Maron, B. J., Bellotti, P., Chiarella, F., & Vecchio, C. (1986) · The American Journal of Cardiology · doi:10.1016/0002-9149(86)90365-6 · Cited by 52 · see citing works
Clinical review 36: Cardiovascular manifestations of endocrine disease
Klein, I. L., & Ojamaa, K. (1992) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.75.2.1639931 · Cited by 50 · see citing works
Kahaly, G. J., Mohr-Kahaly, S., Beyer, J. ̈., & Meyer, J. ̈. (1995) · The American Journal of Cardiology · doi:10.1016/s0002-9149(99)80641-9 · Cited by 37 · see citing works
Decreased adrenergic sensitivity in patients with hypothyroidism
Polikar, R., Kennedy, B. P., Maisel, A., Ziegler, M. G., Smith, J., Dittrich, H. C., & NICOD, P. H. (1990) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(90)90182-o · Cited by 37 · see citing works
Effect of hyperthyroidism of short duration on cardiac sensitivity to beta-adrenergic stimulation
Martin, W. H., Spina, R. J., & Korte, E. (1992) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(92)90322-e · Cited by 29 · see citing works
Doppler echocardiographic evaluation of left ventricular diastolic function in acute hypothyroidism
Grossmann, G., Wieshammer, S., Keck, F. S., Göller, V., Giesler, M., & Hombach, V. (1994) · Clinical Endocrinology · doi:10.1111/j.1365-2265.1994.tb02473.x · Cited by 20 · see citing works
Sbaï, A., Wechsler, B., Leenhardt, L., Beaufils, H., Hoang, C., Ménégaux, F., & Pietté, J. C. (2001) · Thyroid · doi:10.1089/10507250152039163 · Cited by 15 · see citing works
Bernstein, R. M., Midtbø, K., Urdal, P., Mørkrid, L., Smith, G., Müller, C., Bjøro, T., & Haug, E. (1997) · Thyroid · doi:10.1089/thy.1997.7.415 · Cited by 13 · see citing works
Asymmetric septal hypertrophy and hypothyroidism in children.
Altman, D. I., Murray, J., Milner, S., Dansky, R., & Levin, S. E. (1985) · Heart · doi:10.1136/hrt.54.5.533 · Cited by 12 · see citing works
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Cited by
Sorted by citations
Jonklaas, J., Bianco, A. C., Bauer, A. J., Burman, K. D., Cappola, A. R., Celi, F. S., Cooper, D. S., Kim, B. W., Peeters, R. P., Rosenthal, M. S., et al. (2014) · Thyroid® · doi:10.1089/thy.2014.0028 · Cited by 1,928 · see citing works
The Clinical Significance of Subclinical Thyroid Dysfunction
Biondi, B., & Cooper, D. S. (2008) · Endocrine Reviews · doi:10.1210/er.2006-0043 · Cited by 1,418 · see citing works
Thyroid hormones and cardiovascular disease
Jabbar, A., Pingitore, A., Pearce, S. H. S., Zaman, A., Iervasi, G., & Razvi, S. (2017) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2016.174 · Cited by 729 · see citing works
Hypothyroidism as a Risk Factor for Cardiovascular Disease
Biondi, B., & Klein, I. L. (2004) · Endocrine · doi:10.1385/endo:24:1:001 · Cited by 411 · see citing works
Pingitore, A., Galli, E., Barison, A., Iervasi, A., Scarlattini, M., Nucci, D., L’Abbate, A., Mariotti, R., & Iervasi, G. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2007-2210 · Cited by 279 · see citing works
Thyroid hormone and blood pressure regulation
Danzi, S., & Klein, I. (2003) · Current Hypertension Reports · doi:10.1007/s11906-003-0060-7 · Cited by 261 · see citing works
Endocrine Disorders and Cardiovascular Disease
Klein, I. L. (2012) · Elsevier eBooks · doi:10.1016/b978-1-4377-0398-6.00086-x · Cited by 54 · see citing works
Abdel-Moneim, A., Gaber, A. M., Gouda, S., Osama, A., Othman, S. I., & Allam, G. (2020) · Hormones · doi:10.1007/s42000-020-00208-8 · Cited by 45 · see citing works
Tiryakioğlu, S. K., Tiryakioğlu, O., Arı, H., Başel, M. C., Özkan, H., & Bozat, T. (2010) · Echocardiography · doi:10.1111/j.1540-8175.2009.01043.x · Cited by 24 · see citing works
Regalbuto, C., Alagona, C., Maiorana, R., Paola, R. D., Cianci, M., Alagona, G., Sapienza, S., Vigneri, R., & PEZZINO, V. (2006) · Journal of Endocrinological Investigation · doi:10.1007/bf03349174 · Cited by 24 · see citing works
Neves, J. S., Vale, C., von Hafe, M., Borges‐Canha, M., Leite, A. R., Almeida‐Coelho, J., Lourenço, A. P., Falcão‐Pires, I., Carvalho, D. M., & Leite-Moreira, A. F. (2020) · Therapeutic Advances in Endocrinology and Metabolism · doi:10.1177/2042018820958331 · Cited by 24 · see citing works
Cardiovascular Manifestations of Endocrine Dysfunction
Deegan, R., & Furman, W. R. (2011) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2010.12.001 · Cited by 21 · see citing works
Tatar, E., Kırçelli, F., & Ok, E. (2012) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2012.10.068 · Cited by 14 · see citing works
Öner, T., Özdemir, R., Doksöz, Ö., Yozgat, Y., Karadeniz, C., Demirpençe, S., Yılmazer, M. M., Büyükinan, M., Meşe, T., & Tavlı, V. (2015) · Journal of Clinical Research in Pediatric Endocrinology · doi:10.4274/jcrpe.1969 · Cited by 11 · see citing works
Respiratory Failure with Myxedema Ascites in a Patient with Idiopathic Myxedema
Gotyo, N., Hiyama, M., Adachi, J., Watanabe, T., & Hirata, Y. (2010) · Internal Medicine · doi:10.2169/internalmedicine.49.3923 · Cited by 4 · see citing works
Répercussions cardiaques des dysthyroïdies avérées
Vinzio, S., Brafin-Busch, M. S., Schlienger, J.-L., & Goichot, B. (2005) · La Presse Médicale · doi:10.1016/s0755-4982(05)84142-9 · Cited by 4 · see citing works
Ycaza, A. E. E. D. (2018) · Revista Colombiana de Cardiología · doi:10.1016/j.rccar.2017.12.001 · Cited by 3 · see citing works
Gated SPECT Findings Revealing Diastolic Dysfunction in Acute Hypothyroidism
Aydın, M., Reyhan, M., Sükan, A., Yapar, A. F., & Aktaş, A. (2007) · Clinical Nuclear Medicine · doi:10.1097/01.rlu.0000252180.95540.64 · Cited by 3 · see citing works
Thyroid Hormones and Cardiovascular Surgery
Gabriel, E. A., & Gabriel, S. A. (2013) · Springer eBooks · doi:10.1007/978-1-4471-4429-8_31 · Cited by 2 · see citing works
Karki, P., Pandey, I., Bhandary, S., Lamsal, M., & Shrestha, N. R. (2014) · Nepalese Heart Journal · doi:10.3126/njh.v11i1.10979 · Cited by 2 · see citing works
Myxedema ascites? A rare presentation of ascites in severe hypothyroidism: A case report and review
Konar, K. D., Pillay, S., & Sookdev, N. (2024) · SAGE Open Medical Case Reports · doi:10.1177/2050313x241282218 · Cited by 1 · see citing works
Anabolic hormones and heart failure with preserved ejection fraction: looking for Ariadne’s thread
Luca, M. D., Crisci, G., Giardino, F., Valente, V., Amaranto, I., Iacono, O., D’Assante, R., Giallauria, F., & Marra, A. M. (2021) · Monaldi Archives for Chest Disease · doi:10.4081/monaldi.2021.1743 · Cited by 1 · see citing works
Hipertiroidismo y sistema cardiovascular: Bases fisiopatológicas y su manifestación clínica
Mantilla, D., Echin, M., & Perel, C. (2010) · Redalyc (Universidad Autónoma del Estado de México) · Cited by 1 · see citing works
Turbulencies during Hypothyroidism Therapy
Koch, H. J., Szecsey, A., & Vogel, M. (2002) · Cardiology · doi:10.1159/000064665
Ghaly, R. F., Haroutunian, A., Candido, K., & Knežević, N. N. (2018) · Surgical Neurology International · doi:10.4103/sni.sni_357_17
Biondi, B., & Kahaly, G. J. (2019) · Springer eBooks · doi:10.1007/978-3-319-72102-6_21
Mishra, S. K., & Gupta, A. (2022) · International Journal of Research in Medical Sciences · doi:10.18203/2320-6012.ijrms20221178
(2016) · Elsevier eBooks · doi:10.1016/b978-0-323-26011-4.09952-6
- Authors
- Virtanen, V. K., Saha, H. H. T., Groundstroem, K. W. E., Salmi, J., & Pasternack, A. I.
- Affiliations
- Tampere University Hospital (FI)
- ORCID
- Virtanen, V.K.
- Venue
- Cardiology
- Publisher
- S. Karger AG
- Published
- 2001
- Volume
- 96
- Issue
- 2
- Pages
- 59-64
- ISSN
- 0008-6312 (ISSN-L)
- 1421-9751
- OpenAlex
- W1976293072
- Cited by
- 29
- References
- 25
- Citations by year
- 2024: 1 · 2022: 1 · 2021: 1 · 2020: 2 · 2019: 1 · 2018: 2 · 2016: 2 · 2015: 1 · 2014: 2 · 2013: 1 · 2012: 2
- FWCI
- 0.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Tays
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Keywords
- primary hypothyroidism, left ventricular diastolic function, isovolumic relaxation time, E/A ratio, left ventricular wall thickness, heart rate, thyroid hormone replacement
- MeSH terms
- Adolescent, Adult, Aged, Blood Pressure, Diastole, Female, Heart Atria, Heart Rate, Heart Septum, Heart Ventricles, Humans, Hypothyroidism, Middle Aged, Thyrotropin, Thyroxine, Time Factors, Reproducibility of Results, Ventricular Function, Left, Echocardiography, Doppler, Pulsed
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