Coronary Vasoreactivity in Subjects with Thyroid Autoimmunity and Subclinical Hypothyroidism Before and After Supplementation with Thyroxine

Traub-Weidinger, Tatjana; Graf, Senta; Beheshti, Mohsen; Ofluoglu, Sedat; Zettinig, Georg; Khorsand, Aliasghar; Nekolla, Stephan G.; Kletter, Kurt; Dudczak, Robert; Pirich, Christian

doi:10.1089/thy.2011.0183

Cited by 22 publications

(15 citation statements)

References 46 publications

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“…However, several PET scan studies of DCM patients suggest they may also have impaired coronary blood flow due to microvascular alterations (211,248). Several studies have also shown impaired coronary blood flow in noncardiac patients with scHypo (15,244), largely reversible with TH treatment. The high incidence of low TH function in DCM patients, coupled with the likely presence of impaired coronary blood flow from this condition, suggests that many from this patient group may benefit from TH treatment.…”

Section: Low Thyroid Function and Heart Diseasementioning

confidence: 99%

Thyroid Hormone and Cardioprotection

Gerdes

Ojamaa

2016

Comprehensive Physiology

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The heart is a major target of thyroid hormones, with maintenance of euthyroid hormone balance critical for proper function. In particular, chronic low thyroid function can eventually lead to dilated heart failure with impaired coronary blood flow. New evidence also suggests that heart diseases trigger a reduction in cardiac tissue thyroid hormone levels, a condition that may not be detectible using serum hormone assays. Many animal and clinical studies have demonstrated a high prevalence of low thyroid function in heart diseases with worse outcomes from this condition. Animal and human studies have also demonstrated many benefits from thyroid hormone treatment of heart diseases, particularly heart failure. Nonetheless, this potential treatment has not yet translated to patients due to a number of important concerns. The most serious concern involves the potential of accidental overdose leading to increased arrhythmias and sudden death. Several important clinical studies, which actually used excessive doses of thyroid hormone analogs, have played a major role in convincing the medical community that thyroid hormones are simply too dangerous to be considered for treatment in cardiac patients. Nonetheless, this issue has not gone away due primarily to overwhelmingly positive evidence for treatment benefits and a new understanding of the cellular and molecular mechanisms underlying those benefits. This review will first discuss the clinical evidence for the use of thyroid hormones as a cardioprotective agent and then provide an overview of the cellular and molecular mechanisms underlying beneficial changes from thyroid hormone treatment of heart diseases. © 2016 American Physiological Society. Compr Physiol 6:1199-1219, 2016.

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Section: Low Thyroid Function and Heart Diseasementioning

confidence: 99%

Thyroid Hormone and Cardioprotection

Gerdes

Ojamaa

2016

Comprehensive Physiology

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“…There is an association between subclinical hypothyroidism (SCH) and increased risk for cardiovascular disease as shown in a study performed by Traub-Weidinger et al examining coronary vascular reactivity in asymptomatic patients with SCH before and after levothyroxine (LT4) supplementation [41]. In asymptomatic subjects with SCH due to thyroid autoimmunity, coronary microvascular function was impaired and improved after supplementation with LT4.…”

Section: Hormonal Influences On Vascular Reactivity: At the Heart mentioning

confidence: 99%

“…In asymptomatic subjects with SCH due to thyroid autoimmunity, coronary microvascular function was impaired and improved after supplementation with LT4. These findings may explain the increased cardiovascular risk attributed to SCH [41]. …”

Section: Hormonal Influences On Vascular Reactivity: At the Heart mentioning

confidence: 99%

Coronary Microvascular Function and Beyond: The Crosstalk between Hormones, Cytokines, and Neurotransmitters

Lin

Tona

Osto

2015

International Journal of Endocrinology

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Beyond its hemodynamic function, the heart also acts as a neuroendocrine and immunoregulatory organ. A dynamic communication between the heart and other organs takes place constantly to maintain cardiovascular homeostasis. The current understanding highlights the importance of the endocrine, immune, and nervous factors to fine-tune the crosstalk of the cardiovascular system with the entire body. Once disrupted, this complex interorgan communication may promote the onset and the progression of cardiovascular diseases. Thus, expanding our knowledge on how these factors influence the cardiovascular system can lead to novel therapeutic strategies to improve patient care. In the present paper, we review novel concepts on the role of endocrine, immune, and nervous factors in the modulation of microvascular coronary function.

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“…As a consequence of these alterations, hypothyroid patients develop reduced renal perfusion, impaired coronary blood flow, increased arterial stiffness, and accelerated development of atherosclerosis [5][6][7][8]. Subclinical hypothyroidism has also been linked to impaired coronary blood flow in non-cardiac patients and is reversible with treatment [9,10]. A recent human study demonstrated that hypothyroid patients also exhibit high levels of vascular injury markers, closely associated with increased intima-media thickness in the common carotid artery [11,12].…”

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confidence: 99%