Hyperthyroidism and pulmonary hypertension

Marvisi, Maurizio; Brianti, Marco; Marani, G; Borello, P Del; Bortesi, M. L.; Guariglia, A

doi:10.1053/rmed.2001.1260

Cited by 69 publications

(62 citation statements)

References 29 publications

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“…There is a strong relationship between hyperthyroidism and pulmonary hypertension, and hyperthyroid patients may develop right ventricular failure (63,64,65,66,67,68,69,70). In several case reports, isolated right HF, severe right ventricle volume overload and tricuspid regurgitation have been attributed to hyperthyroidism (52,53,64,65,66).…”

Section: Hf In Hyperthyroidismmentioning

confidence: 99%

MECHANISMS IN ENDOCRINOLOGY: Heart failure and thyroid dysfunction

Biondi

2012

European Journal of Endocrinology

248

187

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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 O10 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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Section: Hf In Hyperthyroidismmentioning

confidence: 99%

MECHANISMS IN ENDOCRINOLOGY: Heart failure and thyroid dysfunction

Biondi

2012

European Journal of Endocrinology

248

187

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“…(9) In another study, involving 114 patients with hyperthyroidism (47 with Graves' disease and 67 with multinodular goiter), the prevalence of PAH was found to be 43%. (10) In those two studies, a diagnosis of PAH was made when PASP, as estimated by echocardiography, was > 30 mmHg.…”

Section: Prevalence Of Pah In Patients With Thyroid Diseasesmentioning

confidence: 96%

“…Recent studies have suggested an association between PAH and thyroid diseases (hypothyroidism and hyperthyroidism). (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23) Since the Third World Conference on Pulmonary Hypertension, held in 2003, thyroid diseases have been classified as diseases associated with PAH. (2) However, although some pathogenic mechanisms have been proposed, the nature of this association has not yet been established (Chart 2).…”

Section: Pulmonary Arterial Hypertensionmentioning

confidence: 99%

Hipertensão arterial pulmonar e doenças da tireoide

et al. 2009

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Recent studies have suggested an association between pulmonary arterial hypertension (PAH) and thyroid diseases (hypothyroidism and hyperthyroidism). This combination has a good prognosis, because the increase in the pulmonary artery pressure is usually slight and reverses after the treatment of the thyroid disease. Although the exact mechanism involved in the pathogenesis of this combination has not yet been established, it has been hypothesized that thyroid hormones and autoimmunity have a direct influence. Due to the high prevalence of thyroid disease in patients with PAH, thyroid function tests should be considered in the investigation of every patient with PAH. In this review, we describe the prevalence of PAH in patients with thyroid diseases and the prevalence of thyroid disease in patients with PAH, as well as addressing the principal effects that thyroid diseases have on the respiratory system. In addition, we report the treatment effects in patients with these diseases.Keywords: Hypertension, pulmonary; Graves disease; Hyperthyroidism; Hypothyroidism; Thyroid hormones; Echocardiography. ResumoEstudos recentes têm sugerido uma associação entre hipertensão arterial pulmonar (HAP) e tireoidopatias (hipotireoidismo e hipertireoidismo). Esta associação tem um bom prognóstico, porque o aumento na pressão da artéria pulmonar geralmente é leve e reversível com o tratamento da tireoidopatia. O mecanismo exato envolvido na patogênese desta associação não está estabelecido, e a influência direta dos hormônios da tireoide e a autoimunidade são consideradas como hipóteses. Devido à alta prevalência de doenças da tireoide em pacientes com HAP, testes de função tireoidiana devem ser considerados na investigação de todo paciente com HAP. Neste artigo de revisão, descrevemos a prevalência de HAP em pacientes com doenças da tireoide e a prevalência de tireoidopatias em pacientes com HAP, assim como destacamos os principais efeitos das doenças da tireoide no sistema respiratório. A seguir, relatamos os efeitos do tratamento destas patologias.

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“…1,2 The exact mechanisms responsible for this effect on pulmonary vascular pressure are not well understood. Persistent pulmonary hypertension (PPHN), a major cause of morbidity and death among term newborns, 3 is associated with perinatal asphyxia and perhaps chronic intrauterine hypoxia.…”

mentioning

confidence: 99%

Neonatal Thyrotoxicosis and Persistent Pulmonary Hypertension Necessitating Extracorporeal Life Support

Oden

Cheifetz

2005

Pediatrics

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ABSTRACT. We report a case of neonatal Graves' disease involving an infant with severe persistent pulmonary hypertension (PPHN) associated with neonatal thyrotoxicosis that necessitated extracorporeal membrane oxygenation. Hyperthyroidism, although uncommon in the newborn period, has been associated with pulmonary hypertension among adults. The exact mechanisms responsible for this effect on pulmonary vascular pressure are not well understood. Recent studies have provided evidence that thyrotoxicosis has direct and indirect effects on pulmonary vascular maturation, metabolism of endogenous pulmonary vasodilators, oxygen economy, vascular smooth muscle reactivity, and surfactant production, all of which may contribute to the pathophysiologic development of PPHN. Therefore, because PPHN is a significant clinical entity among term newborns and the symptoms of hyperthyroidism may be confused initially with those of other underlying disorders associated with PPHN (eg, sepsis), it would be prudent to perform screening for hyperthyroidism among affected newborns. ABBREVIATIONS. PPHN, persistent pulmonary hypertension; PVR, pulmonary vascular resistance; ECMO, extracorporeal membrane oxygenation; NO, nitric oxide; NOS, nitric oxide synthase; TTF-1, thyroid transcription factor-1; ADMA, asymmetricH yperthyroidism, although uncommon in the newborn period, has been associated with pulmonary hypertension among adults. 1,2 The exact mechanisms responsible for this effect on pulmonary vascular pressure are not well understood. Persistent pulmonary hypertension (PPHN), a major cause of morbidity and death among term newborns, 3 is associated with perinatal asphyxia and perhaps chronic intrauterine hypoxia. Acute hypoxemia induces pulmonary vasoconstriction, whereas prolonged hypoxia causes hypertrophy of the smooth muscle layer of the small pulmonary arterioles, resulting in persistently elevated pulmonary vascular tone. 3 In either situation, increased pulmonary vascular resistance (PVR) causes a subsequent increase in right ventricular pressure, a patent foramen ovale, and a patent ductus arteriosis in the postnatal period. The resultant, potentially severe, right-to-left shunting is the hallmark of PPHN. Infants with severe PPHN may require extracorporeal membrane oxygenation (ECMO) for adequate oxygen delivery until the elevated PVR resolves.Although the pathophysiologic development of PPHN is multifactorial, certain conditions, such as congenital diaphragmatic hernia, cyanotic congenital heart disease, and sepsis, predispose infants to elevated PVR. These conditions are associated with hypoxia, acidosis, and elevated levels of proinflammatory cytokines. This environment promotes altered vasodilator synthesis and increased vasoconstriction through several poorly defined pathways. Interestingly, thyrotoxicosis is associated with similar clinical and biochemical findings.The association between hyperthyroidism and pulmonary hypertension is unclear. Thyroid hormone has dramatic and contrasting effects on the cardiovascular sy...

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Hyperthyroidism and pulmonary hypertension

Cited by 69 publications

References 29 publications

MECHANISMS IN ENDOCRINOLOGY: Heart failure and thyroid dysfunction

MECHANISMS IN ENDOCRINOLOGY: Heart failure and thyroid dysfunction

Hipertensão arterial pulmonar e doenças da tireoide

Neonatal Thyrotoxicosis and Persistent Pulmonary Hypertension Necessitating Extracorporeal Life Support

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