Endocrine cardiomyopathy: A review and pooled analysis of pathophysiology, diagnosis and clinical management

Abstract

Evidence associating endocrinopathies such as diabetes, thyroid and growth hormone disorders with cardiomyopathies (CMs) and heart failure (HF) has been longestablished. Initially, endocrine disorders were considered an independent risk factor for the development of HF. However, increasing diagnosis of endocrine disorders in patients with CM suggest the involvement of hormones in the pathogenesis of CMs. Moreover, the success of hormonal replacement therapies in a sub-population of patients diagnosed with dilated cardiomyopathy (DCM) provides additional evidence for the role of hormones in the pathophysiology of CMs. In addition, identifying endocrine disorders able to cause CM is important since early initiation of hormonal replacement therapy or surgery can normalize hormonal levels and potentially reverse cardiac dysfunction. However, specific guidelines for the diagnosis and management of endocrine CM are lacking. This has been partly occasioned by a paucity of clinical trials specific to endocrine CM attributed to a disproportionate focus of CM literature on the long-established morphofunctional forms of CM, particularly dilated, hypertrophic and restrictive CMs. Thus, this paper reviews current published data on endocrine CM. In particular, the paper discusses specific endocrine disorders capable of causing CM including their pathophysiology diagnosis and treatment.

Panhypopituitarism Mimicking Acute Coronary Syndrome

“…Supplementation with thyroid and adrenal hormones improved QT prolongation and tent-like Twaves on the ECG, and TdT did not recur. Albakri et al reported a case of cardiogenic shock due to self-interruption of hormone replacement after pituitary adenoma removal (15). They described the role of the pituitary gland in maintaining proper cardiovascular status.…”

Effective use of genetically-encoded optical biosensors for profiling signalling signatures in iPSC-CMs derived from idiopathic dilated cardiomyopathy patients

“…In addition, endocrine dysfunction and certain metabolic syndromes have been linked with the disease (12,13). Dilated cardiomyopathy can occur secondarily to neuromuscular causes (14).…”

“…Of significance, certain chemotherapeutic agents have important side effects that progress towards a DCM phenotype either acutely or years after administration (8–11). In addition, endocrine dysfunction and certain metabolic syndromes have been linked with the disease (12,13). Dilated cardiomyopathy can occur secondarily to neuromuscular causes (14).…”

Endocrine causes of heart failure: A clinical primer for cardiologists

“…Prior reviews have dealt with pathophysiology and cardiac manifestations of various endocrine disorders. 2 , 3 Here, we shall discuss endocrine disorders with potential of index presentation with HF. Except for thyroid disorders, pheochromocytoma/paraganglioma (PPGL) and primary hyperaldosteronism, other disorders dealt in this review have rare presentations.…”