Improvement in functional capacity after levothyroxine treatment in patients with chronic heart failure and subclinical hypothyroidism

Grasiosi, Jorge Curotto; Peressotti, Bruno; Machado, Rogelio A.; Filipini, Eduardo; Angel, A.; Delgado, Jorge; Quiroga, Gustavo Aníbal Cortez; Mansilla, Carmen Rus; Quesada, María del Mar Martínez; Degregorio, Alejandro; Cordero, Diego J.; Dak, Marcelo; Izurieta, Carlos; Esper, Ricardo J.

doi:10.1016/j.endoen.2013.10.013

Cited by 10 publications

(4 citation statements)

References 29 publications

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“…Furthermore, the administration of dobutamine (10 µg/Kg/min) (a direct-acting inotropic agent and an adrenergic agonist that primarily stimulates the β1adrenoceptors, increases myocardial contractility and stroke volume, also reducing peripheral vascular resistance and ventricular filling pressure) improved cardiac output and heart rate in T4-treated patients (n = 10), suggesting enhanced cardiac adrenergic sensitivity, in line with experimental data showing β1-adrenergic up-regulation via TH (38). Moreover, in the study of Curotto Grasiosi, T4 administration in HF-SCH patients (n = 163) improved functional capacity and physical performance (32). In acute decompensated HF patients (n = 20), unresponsive to conventional inotropic therapy and intra-aortic balloon counterpulsation, the positive hemodynamic effect of intravenous T4 administration (20 µg/h) was documented and maintained for enough time to complete surgical treatment consisting of heart transplantation or left ventricular device (33).…”

Section: Thyroxine Treatmentsupporting

confidence: 69%

“…Several clinical studies report different data on TH replacement therapy regarding methodologies using short-term and longterm TH replacement therapy, T3 or T4 at different doses, and modality of administration. In addition, there are differences in the population cohorts in which these treatments are adopted, including HF patients with a normal or abnormal TH profile or with stable or unstable HF (29)(30)(31)(32)(33)(34)(35)(36)(37). Thus, conclusions are far from being definitive and widely shared by the scientific community.…”

Section: Th Treatment In Hf Patientsmentioning

confidence: 99%

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Cardioprotection and Thyroid Hormones in the Clinical Setting of Heart Failure

et al. 2020

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Ischemic heart disease is the main cause of morbidity and mortality worldwide and is becoming more widespread with population aging. Cardioprotection is a dynamic process characterized by mechanisms related to myocardial damage and activation of protective factors. Targeting these processes could be attractive as a new therapeutic strategy in the evolution of post-ischemic heart failure (HF). In this context, the role of thyroid hormone (TH)-mediated cardioprotection is supported by a number of findings regarding the modulation of neuroendocrine systems, inflammatory and oxidative stress status, pro-survival intracellular pathways, and epigenetic factors, its effects on cardiac angiogenesis, structure, and function and on the preservation of mitochondrial function and morphology, and its beneficial effects on cell growth and redifferentiation. Moreover, the numerous effects of TH on the heart involve genomic mechanisms, which include cardiac differentiation during the perinatal period and non-genomic action, directed toward the maintenance of cardiovascular homeostasis. This evidence suggests that there is an opportunity to treat HF patients with TH. This review is mainly focused on the clinical evidence of the role of the thyroid system in the complex setting of HF.

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Section: Thyroxine Treatmentsupporting

confidence: 69%

Section: Th Treatment In Hf Patientsmentioning

confidence: 99%

Cardioprotection and Thyroid Hormones in the Clinical Setting of Heart Failure

et al. 2020

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“…When a large cohort of pre-existing heart failure patients (Pen Heart Failure Study) evaluated for thyroid hormone status and CV composite endpoints, including ventricular assist device placement, heart failure, heart transplant or death, significant associations were noted: a three-fold increase in the risk of composite end point, if TSH ≥ 7and a two-fold increase, if there was isolated low T3 (81). In a study of 163 chronic HF patients with SH who were treated with L-T4 for 6 months, their physical performance was significantly improved, when normal TSH levels were reached (82).…”

Section: Heart Failurementioning

confidence: 99%

Hypothyroidism: Cardiovascular Endpoints of Thyroid Hormone Replacement

2020

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Thyroid dysfunction, either thyrotoxicosis or hypothyroidism, represents an important cardiovascular risk factor. Heart disease is the leading cause of death for men and women in the United States. Cardiovascular disease is multifactorial and many efforts have been made to assess precipitants for optimal guideline-based, primary, and secondary prevention. Thyroid hormone receptors are present in the myocardium and endothelium, and small alterations in its levels could have significant effects in cardiac function. Specifically, overt hypothyroidism is associated with an increased risk for atherosclerotic cardiovascular disease due to metabolic and hemodynamic effects. Several concomitant factors like impaired lipid profile, low-grade chronic inflammatory state, increased oxidative stress and increased insulin resistance enforce this relationship. The last decade has seen a renewed interest on the impact of subclinical hypothyroidism on the cardiovascular system and whether or not it should be treated. The aim of this review is to provide current evidence of the effect of thyroid hormone replacement, either with levothyroxine mono-therapy or in combination with liothyronine, on specific cardiovascular parameters.

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“…In HF and AMI patients, thyroxine and triiodothyronine were both used. Table 2 summarizes the main characteristics and findings of these studies in HF patients [117][118][119][120][121][122][123][124][125]. In general, the studies were carried out in a few of patients with different clinical characteristics and with different targets, mainly functional and morphological ones.…”

Section: Th Replacement Therapy In Heart Failure and Acute Myocardial...mentioning

confidence: 99%

Thyroid and Heart: A Fatal Pathophysiological Attraction in a Controversial Clinical Liaison

Pingitore,

Mastorci,

Lazzeri

et al. 2023

Endocrines

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The thyroid–heart relationship has a long and articulated history of its own, a history that encompasses physiological and pathophysiological knowledge. In recent years, molecular biology studies, in an experimental context, have highlighted the extraordinary dialogue that exists among the two systems in the field of cardioprotection, which is an extremely important area for the treatment of cardiac diseases in both acute and chronic phases. In addition, in the last few years, several studies have been carried out on the prognostic impact of alterations in thyroid function, including subclinical ones, in heart disease, in particular in heart failure and acute myocardial infarction, with evidence of a negative prognostic impact of these and, therefore, with the suggestion to treat these alterations in order to prevent cardiac events, such as death. This review provides a comprehensive summary of the heart–thyroid relationship.

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Improvement in functional capacity after levothyroxine treatment in patients with chronic heart failure and subclinical hypothyroidism

Cited by 10 publications

References 29 publications

Cardioprotection and Thyroid Hormones in the Clinical Setting of Heart Failure

Cardioprotection and Thyroid Hormones in the Clinical Setting of Heart Failure

Hypothyroidism: Cardiovascular Endpoints of Thyroid Hormone Replacement

Thyroid and Heart: A Fatal Pathophysiological Attraction in a Controversial Clinical Liaison

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