Recombinant Human Thyrotropin Reduces Endothelium-Dependent Vasodilation in Patients Monitored for Differentiated Thyroid Carcinoma

Dardano, Angela; Ghiadoni, Lorenzo; Plantinga, Yvonne; Caraccio, N; Bemi, A; Duranti, Emiliano; Taddei, Stefano; Ferrannini, Eleuterio; Salvetti, Antonio; Monzani, Fabio

doi:10.1210/jc.2006-0440

Cited by 104 publications

(78 citation statements)

References 18 publications

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“…Endothelial-dependent vasodilation is inversely correlated with the administration of recombinant human TSH and serum TSH levels (35,36). In concordance with the results of these trials, our findings made us think that high TSH concentration may make SCH patients more prone to dyslipidemia and endothelial dysfunction, and thus, lead to impaired wall movements in the ascending aorta.…”

Section: Discussionsupporting

confidence: 88%

Assessment of the elasticity properties of the ascending aorta in patients with subclinical hypothyroidism by tissue Doppler imaging

Yurtdaş¹,

Gen

Özcan

et al. 2013

Arq Bras Endocrinol Metab

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Objective: We aimed to investigate whether aortic elastic properties were affected in subclinical hypothyroidism (SCH) by using tissue Doppler imaging (TDI). Subjects and methods: Forty-three patients with newly diagnosed SCH and forty-eight healthy controls were included to the study. Systolic and diastolic diameters of the ascending aorta were measured by M-mode transthoracic echocardiography, and the upper wall velocities of ascending aorta and mitral annulus velocities were measured by TDI. Aortic stiffness index (ASI) and aortic distensibility were computed using the formulas accepted in literature. Results: The clinical and demographic features of both groups were comparable. Aortic distensibility was significantly lower, and ASI was significantly higher in SCH patients than in controls. Systolic aortic upper wall velocity (Sao) was also significantly lower in SCH patients. Early (Eao) and late diastolic aortic upper wall (Aao) velocities did not differ between the two groups. Mitral annulus (Sm, Em, and Am) velocities were also similar between the groups. Sao was negatively correlated with ASI, and positively correlated with aortic distensibility. TSH level was positively correlated with ASI, total cholesterol and low-density lipoprotein-cholesterol, and negatively correlated with aortic distensibility and Sao. Conclusions: In this study, our results showed that SCH is associated with impaired elasticity of the ascending aorta. Elastic properties of the ascending aorta can be directly evaluated by the reproducibly measurement of the upper wall movements of the ascending aorta by TDI in SCH patients. Arq Bras Endocrinol Metab. 2013;57(2):132-8 Keywords Tissue Doppler imaging; subclinical hypothyroidism; stiffness RESUMO Objetivo: Nosso objetivo foi investigar se as propriedades elásticas da aorta são afetadas no hipotireoidismo subclínico (HSC), utilizando o Doppler tecidual (UDT). Sujeitos e métodos: Quarenta e três pacientes com diagnóstico recente de HSC e 48 indivíduos saudáveis foram incluí-dos no estudo. Os diâmetros sistólico e diastólico da aorta foram medidos por ecocardiografia transtorácica modo M e as velocidades de fluxo da parede superior da aorta ascendente e de fluxo transvalvar mitral foram medidas por UDT. O índice de rigidez da aorta (IRA) e a distensibilidade aórtica foram calculados usando fórmulas aceitas na literatura. Resultados: As características clínicas e demográficas dos dois grupos foram comparáveis. A distensibilidade aórtica foi significativamente menor e IRA significativamente maior nos pacientes com HSC do que nos controles. A velocidade de fluxo sistólico na parede aórtica superior (Sao) foi significantemente menor em pacientes com HSC. A velocidade de fluxo diastólico inicial (Eao) e tardio (Aao) na parede aórtica superior e as velocidades de fluxo transvalvar (Sm, Em e Am) não diferiram entre os dois grupos. Sao foi negativamente correlacionada com IRA e positivamente correlacionada com a distensibilidade aórtica. O nível de TSH foi positivamente correlacionado ...

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Section: Discussionsupporting

confidence: 88%

Assessment of the elasticity properties of the ascending aorta in patients with subclinical hypothyroidism by tissue Doppler imaging

Yurtdaş¹,

Gen

Özcan

et al. 2013

Arq Bras Endocrinol Metab

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“…When compared with euthyroid patients. elevated serum triglycerides and LDL-C levels have been reported in SCH patients [35]. In our study.…”

Section: Discussionsupporting

confidence: 58%

The evaluation of aortic elasticity in subclinical hypothyroidism

Özkan¹,

Tarım²,

Demirtunç³

et al. 2015

MMJ

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Objective: In this study we evaluated the elastic properties of the aorta in patients with subclinical hypothyroidism and their relation with left ventricular diastolic function by transthoracic echocardiography.Patients and Methods: Aortic transthoracic echocardiography was performed and the aortic elasticity was evaluated using the following parameters; strain, the beta index and distensibility.results: There was significant difference in terms of aortic strain (5.79% vs. 9.45% p <0.001) and distensibility (4.64 versus 3.02 10-3.cm2. dyn-1. p <0.005) between the control group and patients with subclinical hypothyroidism group. In the subclinical hypothyroidism group the average mitral early diastolic velocity (E). (p <0.05) were significantly lower than the mean mitral diastolic flow velocity / mitral late diastolic flow velocity (E / A) (p <0.01) observed in the control group. and higher than the mean mitral late diastolic flow velocity (A) and isovolumetric relaxation time (IVRT) (P <0.05) in the control group.conclusions: In patients with subclinical hypothyroidism an increase in the aortic stiffness was observed. The diastolic dysfunction observed in subclinical hypothyroidism is mainly responsible for the increase in the aortic stiffness.

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“…They suggest that the effect of TSH on endothelial function is probably mediated by its interaction with the TSH receptors present on endothelial cells. Other studies have demonstrated that rhTSH administration induced endothelial function impairment (30,31). VWF activity could be considered as a marker of endothelium dysfunction in patients with cardiovascular disease (32,33).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the respective influence of thyroid hormones and TSH on blood coagulation parameters after total thyroidectomy

Yango¹,

Alexopoulou²,

Eeckhoudt

et al. 2011

European Journal of Endocrinology

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Background: Several hemostatic abnormalities have been described in hypothyroidism, such as modification of coagulation proteins and bleeding tendency. Although thyroid hormone deficiency is considered to be responsible for these changes, the underlying mechanisms have not yet been established. Objective: To evaluate the respective influence of peripheral thyroid hormones (free thyroxine) and TSH on blood clotting by assessing coagulation parameters in patients with a history of total thyroidectomy for thyroid cancer, under three different conditions: induced hypothyroidism, euthyroid state, and following recombinant human TSH (rhTSH) administration. Methods: Coagulation parameters (platelet count, fibrinogen, international normalized ratio, prothrombin time, thrombin time, activated partial thromboplastin time (APTT), factor VIII activity ((FVIII:C), as well as von Willebrand factor antigen (VWF:Ag) and VWF activity using collagen binding assay (VWF:CBA)) were measured in patients with severe hypothyroidism following withdrawal of thyroid hormone replacement therapy, and in the same patients with euthyroidism after restoring replacement treatment (group A), and before and after administering rhTSH (group B). Results: FVIII:C, VWF:Ag, and VWF:CBA were significantly decreased (P!0.001), whereas APTT was significantly increased (P!0.001) in patients with severe hypothyroidism compared with patients in the euthyroid state. No changes in clotting parameters were observed in patients who received rhTSH therapy.Conclusion: This prospective study shows that severe short-term hypothyroidism is associated with significantly lower levels of VWF:Ag, VWF:CBA, and FVIII:C. Administration of exogenous TSH has no effect on coagulation parameters. These findings suggest that thyroid hormone deficiency is likely to be the main cause of coagulation alterations in patients with hypothyroidism.

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Recombinant Human Thyrotropin Reduces Endothelium-Dependent Vasodilation in Patients Monitored for Differentiated Thyroid Carcinoma

Abstract: rhTSH administration acutely impaired endothelium-dependent vasodilation, possibly through the induction of low-grade inflammation and reduced nitric oxide availability by oxidative stress.

Cited by 104 publications

References 18 publications

Assessment of the elasticity properties of the ascending aorta in patients with subclinical hypothyroidism by tissue Doppler imaging

Assessment of the elasticity properties of the ascending aorta in patients with subclinical hypothyroidism by tissue Doppler imaging

The evaluation of aortic elasticity in subclinical hypothyroidism

Evaluation of the respective influence of thyroid hormones and TSH on blood coagulation parameters after total thyroidectomy

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