Thyroid and Cardiovascular Disease

Cappola, Anne R.; Desai, Akshay S.; Medici, Marco; Cooper, Lawton S.; Egan, Debra; Sopko, George; Fishman, Glenn I.; Goldman, Steven; Cooper, David S.; Mora, Samia; Kudenchuk, Peter J.; Hollenberg, Anthony N.; McDonald, Cheryl L.; Ladenson, Paul W.; Celi, Francesco S.; Dillman, Wolfgang; Ellervik, Christina; Gerdes, A. Martin; Ho, Carolyn Y.; Iervasi, Giorgio; Lerman, Amir; Makino, Ayako; Ojamaa, Kaie; Peeters, Robin P.; Pingitore, Alessandro; Razvi, Salman; Wassner, Ari J.

doi:10.1161/circulationaha.118.036859

Cited by 76 publications

(60 citation statements)

References 124 publications

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“…They are guide us when to start and adjusting the antithyroid drug dosage during treatment, particulary if the patient have ventricular rate that is difficult to control with standard treatment. 9 20 mg of propranolol tablets per 8 hours is the drug of choice in hyperthyroidism, with recommended doses of 40-160 mg tablets/day in divided doses.…”

Section: Atrial Fibrillation Was Established Based On Complaints Of Pmentioning

confidence: 99%

“…The patient was not tested for thyroid hormones, neither TSH, free T4, nor T3, due to cost constraints and the hospital availability of such examination. Based on recent guideline, it is very recommended to perform thyroid testing for management of thyroid dysfunction coexistent with cardiovascular disease, especially for patient that have atrial fibrillation and heart failure as like as our patient condition 9.…”

mentioning

confidence: 99%

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Hyperthyroid Heart Disease With Some Comorbidities

Hasanuddin¹,

Dunggio²,

Zubaidi³

2020

GMJ

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Thyroid disease is quite common. The cardiovascular clinical manifestations of hyperthyroidism are palpitation, systolic hypertension, fatigue, or with the basis of existing heart disease, angina or heart failure. In men, the disease is more frequently to develop into congestive heart failure than in women, thus more exploration is needed. This case report discussed a 42-year-old male patient who was admitted to the emergency department due to palpitations, shortness of breath aggravated with activity and lie down position, and alleviated with resting, cough with white sputum, epigastric pain, and constipation since the past 3 days. He was diagnosed with a history of hyperthyroidism and congestive heart disease 1 year ago and routinely consumed propylthiouracil (PTU). He had a history of herniotomy 10 days before admission. The patient did not have a history of hypertension, diabetes mellitus, or hypercholesterolemia. The patient has a smoking habit of up to 3 packs/day since a teenager. The patient was diagnosed with hyperthyroid heart disease (congestive heart failure, atrial fibrillation, and coronary heart disease) with comorbid of electrolyte imbalance, hypoalbuminemia, and thrombocytopenia. The patient was treated in the Intensive Care Unit (ICU) and was given oxygen therapy, crystalloid infusion, antithyroid drug, beta-blocker, diuretics, digitalis, anti-angina, anti-thrombotic, and adjunct therapy. The patient was treated for 8 days in ICU, followed by 2 days in the ward with a good outcome. Early detection and intervention followed by close monitoring is key management for the patient with hyperthyroid heart disease, especially in a male patient, to achieve a better outcome.

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Section: Atrial Fibrillation Was Established Based On Complaints Of Pmentioning

confidence: 99%

mentioning

confidence: 99%

Hyperthyroid Heart Disease With Some Comorbidities

Hasanuddin¹,

Dunggio²,

Zubaidi³

2020

GMJ

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“…TH affect heart metabolism, electrical properties, and function through the interplay of genomic and non-genomic mechanisms of action [17,[19][20][21][22]. Accordingly, chronic and acute changes in the circulating TH have a fundamental impact on cardiac electrophysiology, Ca 2+ handling, and structural remodeling.…”

Section: Introductionmentioning

confidence: 99%

“…Accordingly, chronic and acute changes in the circulating TH have a fundamental impact on cardiac electrophysiology, Ca 2+ handling, and structural remodeling. Disorders of these cellular factors due to a TH imbalance affect the susceptibility of the heart to arrhythmias [4,15,17]. The thyroid gland produces thyroxine (T 4 ), which is a relatively inactive prohormone, and lower amounts of the active hormone, triiodothyronine (T 3 ).…”

Section: Introductionmentioning

confidence: 99%

“…TSH is a sensitive indicator of thyroid function. Subclinical hyperthyroidism is common in the general population and its frequency is variable, depending on age, sex, and iodine status [15][16][17], and has been defined as lower serum TSH levels (<0.10 mlU/L), while the free T 4 and T 3 concentrations are within the reference range. The euthyroid status is defined as the condition wherein the TSH level is within the range from 0.45 to 4.49 mlU/L.…”

Section: Introductionmentioning

confidence: 99%

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Pro-Arrhythmic Signaling of Thyroid Hormones and Its Relevance in Subclinical Hyperthyroidism

Tribulová

Kurahara

Hlivák

et al. 2020

IJMS

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A perennial task is to prevent the occurrence and/or recurrence of most frequent or life-threatening cardiac arrhythmias such as atrial fibrillation (AF) and ventricular fibrillation (VF). VF may be lethal in cases without an implantable cardioverter defibrillator or with failure of this device. Incidences of AF, even the asymptomatic ones, jeopardize the patient’s life due to its complication, notably the high risk of embolic stroke. Therefore, there has been a growing interest in subclinical AF screening and searching for novel electrophysiological and molecular markers. Considering the worldwide increase in cases of thyroid dysfunction and diseases, including thyroid carcinoma, we aimed to explore the implication of thyroid hormones in pro-arrhythmic signaling in the pathophysiological setting. The present review provides updated information about the impact of altered thyroid status on both the occurrence and recurrence of cardiac arrhythmias, predominantly AF. Moreover, it emphasizes the importance of both thyroid status monitoring and AF screening in the general population, as well as in patients with thyroid dysfunction and malignancies. Real-world data on early AF identification in relation to thyroid function are scarce. Even though symptomatic AF is rare in patients with thyroid malignancies, who are under thyroid suppressive therapy, clinicians should be aware of potential interaction with asymptomatic AF. It may prevent adverse consequences and improve the quality of life. This issue may be challenging for an updated registry of AF in clinical practice. Thyroid hormones should be considered a biomarker for cardiac arrhythmias screening and their tailored management because of their multifaceted cellular actions.

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Association of Posttraumatic Stress Disorder and Incident Ischemic Heart Disease in Women Veterans

et al. 2021

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IMPORTANCE Posttraumatic stress disorder (PTSD) is associated with greater risk of ischemic heart disease (IHD) in predominantly male populations or limited community samples. Women veterans represent a growing, yet understudied, population with high levels of trauma exposure and unique cardiovascular risks, but research on PTSD and IHD in this group is lacking. OBJECTIVE To determine whether PTSD is associated with incident IHD in women veterans. DESIGN, SETTING, AND PARTICIPANTSIn this retrospective, longitudinal cohort study of the national Veterans Health Administration (VHA) electronic medical records, the a priori hypothesis that PTSD would be associated with greater risk of IHD onset was tested. Women veterans 18 years or older with and without PTSD who were patients in the VHA from January 1, 2000, to December 31, 2017, were assessed for study eligibility. Exclusion criteria consisted of no VHA clinical encounters after the index visit, IHD diagnosis at or before the index visit, and IHD diagnosis within 90 days of the index visit. Propensity score matching on age at index visit, number of prior visits, and presence of traditional and female-specific cardiovascular risk factors and mental and physical health conditions was conducted to identify women veterans ever diagnosed with PTSD, who were matched in a 1:2 ratio to those never diagnosed with PTSD. Data were analyzed from October 1, 2018, to October 30, 2020. EXPOSURES PTSD, defined by International Classification of Diseases, Ninth Revision (ICD-9), or International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10), diagnosis codes from inpatient or outpatient encounters. MAIN OUTCOMES AND MEASURES Incident IHD, defined as new-onset coronary artery disease, angina, or myocardial infarction, based on ICD-9 and ICD-10 diagnosis codes from inpatient or outpatient encounters, and/or coronary interventions based on Current Procedural Terminology codes.RESULTS A total of 398 769 women veterans, 132 923 with PTSD and 265 846 never diagnosed with PTSD, were included in the analysis. Baseline mean (SD) age was 40.1 (12.2) years. During median follow-up of 4.9 (interquartile range, 2.1-9.2) years, 4381 women with PTSD (3.3%) and 5559 control individuals (2.1%) developed incident IHD. In a Cox proportional hazards model, PTSD was significantly associated with greater risk of developing IHD (hazard ratio [HR], 1.44; 95% CI, 1.38-1.50). Secondary stratified analyses indicated that younger age identified women veterans with PTSD who were at greater risk of incident IHD. Effect sizes were largest for those younger than 40 years at baseline (HR, 1.72; 95% CI, 1.55-1.93) and decreased monotonically with increasing age (HR for Ն60 years, 1.24; 95% CI, 1.12-1.38).CONCLUSIONS AND RELEVANCE This cohort study found that PTSD was associated with increased risk of IHD in women veterans and may have implications for IHD risk assessment in vulnerable individuals.

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Thyroid and Cardiovascular Disease

Cited by 76 publications

References 124 publications

Hyperthyroid Heart Disease With Some Comorbidities

Hyperthyroid Heart Disease With Some Comorbidities

Pro-Arrhythmic Signaling of Thyroid Hormones and Its Relevance in Subclinical Hyperthyroidism

Association of Posttraumatic Stress Disorder and Incident Ischemic Heart Disease in Women Veterans

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