MECHANISMS IN ENDOCRINOLOGY: Heart failure and thyroid dysfunction
Abstract
Context: Heart failure (HF) is a major cause of morbidity and mortality in Europe and in the United States. The aim of this review article was to assess the results of the prospective studies that evaluated the risk of HF in patients with overt and subclinical thyroid disease and discuss the mechanism of this dysfunction. Evidence Acquisition: Reports published with the following search terms were searched:, thyroid, hypothyroidism, hyperthyroidism, subclinical hyperthyroidism, subclinical hypothyroidism, levothyroxine, triiodothyronine, antithyroid drugs, radioiodine, deiodinases, clinical symptoms, heart rate, HF, systolic function, diastolic function, systemic vascular resistance, endothelial function, amiodarone and atrial fibrillation. The investigation was restricted to reports published in English. Evidence Synthesis: The outcome of this analysis suggests that patients with untreated overt thyroid dysfunction are at increased risk of HF. Moreover, persistent subclinical thyroid dysfunction is associated with the development of HF in patients with serum TSH <0.1 or >10 mU/l. Conclusions: The timely recognition and effective treatment of cardiac symptoms in patients with thyroid dysfunction is mandatory because the prognosis of HF may be improved with the appropriate treatment of thyroid dysfunction.
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Stroke is a potential complication of atrial fibrillation in overt hyperthyroidism.
“Stroke is a potential complication of AF in overt hyperthyroidism [68] .”
From The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism (2015) · cites this paper as [68]
These cardiovascular alterations may be reversible or improve when euthyroidism is restored because thyroid hormone excess does not induce cardiac fibrosis.
“These alterations may be reversible or improve when euthyroidism is restored because thyroid hormone excess does not induce cardiac fibrosis [68] .”
From The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism (2015) · cites this paper as [68]
The onset of atrial fibrillation may increase cardiovascular morbidity and mortality from severe heart failure and stroke.
“The onset of AF may increase CV morbidity and mortality, resulting from severe HF and stroke (75).”
From Thyroid Hormones and Cardiovascular Function and Diseases (2018) · cites this paper as [75]
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- Authors
- Biondi, B.
- Affiliations
- Federico II University Hospital (IT)
- Corresponding author
- Biondi, Bernadette
- ORCID
- Biondi, Bernadette
- Venue
- European Journal of Endocrinology
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-11
- Volume
- 167
- Issue
- 5
- Pages
- 609-618
- ISSN
- 0804-4643 (ISSN-L)
- 1479-683X
- OpenAlex
- W2071292391
- Cited by
- 291
- References
- 105
- Citations by year
- 2026: 8 · 2025: 15 · 2024: 13 · 2023: 17 · 2022: 19 · 2021: 26 · 2020: 24 · 2019: 26 · 2018: 23 · 2017: 28 · 2016: 24 · 2015: 23 · 2014: 21 · 2013: 17 · 2012: 3
- FWCI
- 2.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- heart failure, thyroid dysfunction, subclinical hypothyroidism, subclinical hyperthyroidism, overt hypothyroidism, overt hyperthyroidism, thyroid hormone replacement, levothyroxine, triiodothyronine, antithyroid drugs, radioactive iodine, deiodinases, systolic function, diastolic function, endothelial function, amiodarone, atrial fibrillation, heart rate, systemic vascular resistance
- MeSH terms
- Amiodarone, Animals, Anti-Arrhythmia Agents, Atrial Fibrillation, Atrial Flutter, Coronary Disease, Heart Failure, Heart Rate, Humans, Hyperthyroidism, Hypothyroidism, Prognosis, Stroke Volume, Thyroid Diseases, Thyroid Hormones, Thyrotropin, Thyroxine, Triiodothyronine, Practice Guidelines as Topic, Disease Progression, Evidence-Based Medicine
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