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Cited by 445Thyroid Disorders and TreatmentsCardiovascular Function and Risk FactorsCardiac electrophysiology and arrhythmias

Effects of Thyroid Hormone on the Cardiovascular System

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Fazio, S.·2004·Recent Progress in Hormone Research
DOI 10.1210/rp.59.1.31
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Abstract

Increased or reduced action of thyroid hormone on certain molecular pathways in the heart and vasculature causes relevant cardiovascular derangements. It is well established that overt hyperthyroidism induces a hyperdynamic cardiovascular state (high cardiac output with low systemic vascular resistance), which is associated with a faster heart rate, enhanced left ventricular (LV) systolic and diastolic function, and increased prevalence of supraventricular tachyarrhythmias - namely, atrial fibrillation - whereas overt hypothyroidism is characterized by the opposite changes. However, whether changes in cardiac performance associated with overt thyroid dysfunction are due mainly to alterations of myocardial contractility or to loading conditions remains unclear. Extensive evidence indicates that the cardiovascular system responds to the minimal but persistent changes in circulating thyroid hormone levels, which are typical of individuals with subclinical thyroid dysfunction. Subclinical hyperthyroidism is associated with increased heart rate, atrial arrhythmias, increased LV mass, impaired ventricular relaxation, reduced exercise performance, and increased risk of cardiovascular mortality. Subclinical hypothyroidism is associated with impaired LV diastolic function and subtle systolic dysfunction and an enhanced risk for atherosclerosis and myocardial infarction. Because all cardiovascular abnormalities are reversed by restoration of euthyroidism ("subclinical hypothyroidism") or blunted by beta-blockade and L-thyroxine (L-T4) dose tailoring ("subclinical hyperthyroidism"), timely treatment is advisable in an attempt to avoid adverse cardiovascular effects. Interestingly, some data indicate that patients with acute and chronic cardiovascular disorders and those undergoing cardiac surgery may have altered peripheral thyroid hormone metabolism that, in turn, may contribute to altered cardiac function. Preliminary clinical investigations suggest that administration of thyroid hormone or its analogue 3,5-diiodothyropropionic acid greatly benefits these patients, highlighting the potential role of thyroid hormone treatment in patients with acute and chronic cardiovascular disease.

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  • Patients with severe hyperthyroidism may have coronary vasospasm leading to chest pain at rest or myocardial ischemia.

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

    From Thyroid Hormones and Cardiovascular Function and Diseases (2018) · cites this paper as [79]

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Research works printed but not linked: 1

  1. Klein I 1989 Thyroid hormone and high blood pressure. In: Laragh JH, Brenner BM, Kaplan NM, eds. Endocrine Mechanisms in Hypertension, vol. 2. New York: Raven Press; 61-80

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Authors
Fazio, S.
Affiliations
Federico II University Hospital (IT)
Corresponding author
Fazio, S.
ORCID
Fazio, S.
Venue
Recent Progress in Hormone Research
Publisher
The Endocrine Society
Published
2004-01-01
Volume
59
Issue
1
Pages
31-50
ISSN
0079-9963 (ISSN-L)
DOI
10.1210/rp.59.1.31
OpenAlex
W2156400205
Cited by
445
References
117
Citations by year
2026: 7 · 2025: 11 · 2024: 15 · 2023: 20 · 2022: 12 · 2021: 15 · 2020: 16 · 2019: 18 · 2018: 18 · 2017: 28 · 2016: 25 · 2015: 34 · 2014: 21 · 2013: 35 · 2012: 31
FWCI
2.13
Type
journal article
Language
en
Open access
Locations
  • Recent Progress in Hormone Research (publishedVersion)
  • PubMed (publishedVersion)
  • INFM-OAR (INFN Catania) (submittedVersion, other-oa)
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 › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Keywords
thyroid hormones, cardiovascular effects, hyperthyroidism, hypothyroidism, subclinical hyperthyroidism, subclinical hypothyroidism, atrial fibrillation, left ventricular function, heart rate, beta-adrenergic blockade, atherosclerosis, myocardial infarction, cardiovascular mortality, cardiac surgery, thyroid hormone metabolism, thyroid hormone analogs
MeSH terms
Cardiovascular Diseases, Cardiovascular System, Humans, Hyperthyroidism, Hypothyroidism, Thyroid Gland, Thyroid Hormones

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