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Thyroid gland and heart: a cardiologist’s view on an endocrinological pathology. Review

Authors: V. E. Кondratiuk; А. P. Stakhova;

Thyroid gland and heart: a cardiologist’s view on an endocrinological pathology. Review

Abstract

The review of the literature considered the mechanism of action and the role of thyroid hormones (TH) on cardiovascular hemodynamics and, subsequently, on changes in the myocardial structure. A brief description of the genomic and non‑genomic mechanisms of thyroid hormones is provided. The mechanisms of thyroid hormones’ effects on the development of arterial and pulmonary hypertension, atrial fibrillation are highlighted. Attention is focused on the fact that congestive heart failure of the dilatation type develops against the background of hyperthyroidism. A possible connection between thyroid hyperfunction and Takotsubo stress‑induced cardiomyopathy was investigated. The impact of subclinical hyperthyroidism on the development and progression of cardiac pathology is illustrated. The mechanism of influence of hypothyroidism on the parameters of the lipid spectrum, acute phase proteins, insulin sensitivity, but not only the contractile function of the myocardium was considered. Changes in the electrical activity of the heart and its structural and functional changes were determined. Attention is focused on the importance of achieving euthyroidism in both hyperthyroidism and hypothyroidism. Stress‑induced Takotsubo cardiomyopathy is closely related to the hyperthyroid state and is often accompanied by the development of cardiogenic shock. Hyperthyroidism is associated with an increased risk of permanent atrial fibrillation and hypercoagulability. The achievement of euthyroid state can result in the reversal of left ventricular hypertrophy and decrease in the heart chamber dilatation. Even subclinical hyperthyroidism increases the risks of overall mortality and cardiovascular events, especially in the elderly persons. Patients with hypothyroidism are characterized by the development of anemia, dyslipidemia, decreased sensitivity to insulin, which is associated with endothelial dysfunction. In hypothyroidism, in contrast to hyperthyroidism, the risk of atrial fibrillation development is lower due to an increase in the arrhythmogenic threshold, but more typical disorders include sinus bradycardia, atrioventricular blocks of various degrees and prolongation of the QT interval, which are associated with the early development of impaired myocardial relaxation. For patients with thyroid pathology, the achievement of euthyroidism is mandatory to ensure cardio‑ and vasoprotection.

Keywords

кардіоміопатія Такоцубо, dilated cardiomyopathy, гіпотиреоз, гіпертиреоз, hyperthyroidism, hypothyroidism, Takotsubo cardiomyopathy, дилатаційна кардіоміопатія

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
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