Hypothyroidism-induced reversible dilated cardiomyopathy

Rastogi, Prateek; Dua, A.K.; Attri, Savita Verma; Sharma, Hitender

doi:10.4103/jpgm.jpgm_154_17

Cited by 18 publications

(21 citation statements)

References 12 publications

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“…The changes induced by hypothyroid state may effect cardiac contractility that is diastolic in nature impairing myocardial relaxation, which is consistent with previous findings that diastolic dysfunction is the most common finding in hyperthyroid patients [36][37][38]. Associated diastolic hypertension or co-occurring CAD can further impair myocardial diastolic function [39].…”

Section: Thymus Glandsupporting

confidence: 90%

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

Albakri¹

2019

Res Rev Insights

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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.

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Section: Thymus Glandsupporting

confidence: 90%

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

Albakri¹

2019

Res Rev Insights

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“…This interferes with iodine absorption affecting growth, cognitive function, and hormonal balance. Additionally, hypothyroidism has been known to lead to DCM, more specifically hypothyroidism-induced canine DCM ( Rastogi et al, 2018 )…”

Section: Chemical-inherent Compounds and Heavy Metalsmentioning

confidence: 99%

Review of canine dilated cardiomyopathy in the wake of diet-associated concerns

McCauley¹,

Clark²,

Quest³

et al. 2020

Journal of Animal Science

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Abstract Dilated cardiomyopathy (DCM) has been in the literature and news because of the recent opinion-based journal articles and public releases by regulatory agencies. DCM is commonly associated with a genetic predisposition in certain dog breeds and can also occur secondary to other diseases and nutritional deficiencies. Recent communications in veterinary journals have discussed a potential relationship between grain-free and/or novel protein diets to DCM, citing a subjective increase in DCM in dog breeds that are not known to have a genetic predisposition for the disease. This literature review describes clinical presentations of DCM, common sequelae, treatment and preventative measures, histopathologic features, and a discussion of the varied etiological origins of the disease. In addition, current literature limitations are addressed, in order to ascertain multiple variables leading to the development of DCM. Future studies are needed to evaluate one variable at a time and to minimize confounding variables and speculation. Furthermore, to prevent sampling bias with the current FDA reports, the veterinary community should be asked to provide information for all cases of DCM in dogs. This should include cases during the same time period, regardless of the practitioner’s proposed etiology, due to no definitive association between diets with specific characteristics, such as, but not limited to, grain-free diets and those containing legumes, novel protein diets, and those produced by small manufacturers to DCM in dogs. In summary, in order to determine if certain ingredients, categories of diets, or manufacturing processes are related to an increased risk of DCM, further studies investigating these variables are necessary.

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“…Untreated hypothyroid patients have low cardiac output, decreased stroke and vascular volume and increased systemic vascular resistance (4,7). Diastolic dysfunction is a common abnormality reported in hypothyroidism (8). There are studies in the literature showing that especially in women hypothyroidism causes Takotsubo Cardiomyopathy (8,9).…”

Section: Introductionmentioning

confidence: 99%

“…Diastolic dysfunction is a common abnormality reported in hypothyroidism (8). There are studies in the literature showing that especially in women hypothyroidism causes Takotsubo Cardiomyopathy (8,9). Takotsubo Cardiomyopathy is a cardiac syndrome characterized by transient LV dysfunction, electrocardiographic changes that can mimic acute myocardial infarction (MI), and minimal release of myocardial enzymes in the absence of obstructive coronary artery disease (10).…”

Section: Introductionmentioning

confidence: 99%

Hypothyroidism Increases Expression of Sterile Inflammation Proteins in Rat Heart Tissue

et al. 2019

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Purpose. In this study, we aimed to investigate the relationship between hypothyroidism and sterile inflammation in rat heart tissue. Methods. Groups; control group (fed with standard rat chow diet and tab water) and the hypothyroid group (fed with a standard rat chow diet and tap water containing 0.05% 6-n-propyl-2-thiouracil for 6-weeks). At the end of the experiment, histopathologic examination was performed. The T3, T4, TSH and myocardial malondialdehyde (MDA) measurements were performed with an ELISA kit. TUNEL assay was performed to demonstrate apoptosis. Sterile inflammation markers, caspase-1 and NLRP3, were investigated by immunohistochemistry and western blot. Results. In histopathological examination, we observed leukocyte infiltration, myocardial atrophy, pyknotic nucleated cells and cytoplasmic vacuolization in hypothyroid group whereas the control group showed normal structure. MDA levels in myocardial tissue were significantly high in hypothyroid group when compared to the control group (P<0.05). Myocardial apoptosis increased in hypothyroid group when compared to the control group. NLRP3 and caspase-1 immunoreactivity was higher in the hypothyroid group. In ELISA results, we found significantly higher level of TSH and lower levels of T3 and T4 in hypothyroid group when compared to the control group. Conclusion. Hypothyroidism increased oxidative stress, and caused inflammatory alterations in cardiac tissue. In addition, our study also suggested that thyroid hormone deficiency would increase the amounts of cardiac NLRP3 and caspase-1 protein, which indicates that hypothyroidism exerts its destructive effects through sterile inflammation. Elucidation of sterile inflammation-associated pathways may produce promising results in the treatment of hypothyroidism-induced cardiac damage.

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Hypothyroidism-induced reversible dilated cardiomyopathy

Cited by 18 publications

References 12 publications

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

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

Review of canine dilated cardiomyopathy in the wake of diet-associated concerns

Hypothyroidism Increases Expression of Sterile Inflammation Proteins in Rat Heart Tissue

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