Cardiology - Reviews

Thyroid dysfunction on the heart: clinical effects, prognostic impact and management strategies

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Received: 7 November 2021
Published: 24 March 2022
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Thyroid hormones have a considerable influence on cardiac function and structure. There are direct and indirect effects of thyroid hormone on the cardiovascular system, which are prominent in both hypothyroidism and hyperthyroidism. In this review, we discuss how thyroid dysfunction impacts cardiovascular pathophysiology and the underlying molecular mechanisms.

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Irace L, Pergola V, Di Salvo G, et al. Work capacity and oxygen uptake abnormalities in hyperthyroidism. Minerva Cardioangiol 2006;54:355-62.

Biondi B. Mechanisms in endocrinology: Heart failure and thyroid dysfunction. Eur J Endocrinol 2012;167:609–18. DOI: https://doi.org/10.1530/EJE-12-0627

Mitchell JE, Hellkamp AS, Mark DB, et al. Thyroid function in heart failure and impact on mortality. JACC Heart Fail 2013;1:48–55. DOI: https://doi.org/10.1016/j.jchf.2012.10.004

Cittadini A, Salzano A, Iacoviello M, et al. Multiple hormonal and metabolic deficiency syndrome predicts outcome in heart failure: the T.O.S.CA. Registry. Eur J Prev Cardiol 2021;28:1691-700. DOI: https://doi.org/10.1093/eurjpc/zwab020

Iervasi G, Pingitore A, Landi P, et al. Low-T3 syndrome: a strong prognostic predictor of death in patients with heart disease. Circulation 2003;107:708–13. DOI: https://doi.org/10.1161/01.CIR.0000048124.64204.3F

Kannan L, Shaw PA, Morley MP, et al. Thyroid dysfunction in heart failure and cardiovascular outcomes. Circ Heart Fail 2018;11:e005266. DOI: https://doi.org/10.1161/CIRCHEARTFAILURE.118.005266

Klein I, Danzi S. Thyroid disease and the heart. Circulation 2007;116:1725–35. DOI: https://doi.org/10.1161/CIRCULATIONAHA.106.678326

Tomisti L, Materazzi G, Bartalena L, et al. Total thyroidectomy in patients with amiodarone-induced thyrotoxicosis and severe left ventricular systolic dysfunction. J Clin Endocrinol Metab 2012;97:3515–21. DOI: https://doi.org/10.1210/jc.2012-1797

Al-Ghamdi AS, Aljohani N. Graves’ thyrotoxicosis-induced reversible cardiomyopathy: a case report. Clin Med Insights Case Rep 2013;6:47–50. DOI: https://doi.org/10.4137/CCRep.S10534

Choudhury RP, MacDermot J. Heart failure in thyrotoxicosis, an approach to management. Br J Clin Pharmacol 1998;46:421–4. DOI: https://doi.org/10.1046/j.1365-2125.1998.00804.x

Osman F, Franklyn JA, Holder RL, et al. Cardiovascular manifestations of hyperthyroidism before and after antithyroid therapy: a matched case-control study. J Am Coll Cardiol 2007;49:71–81. DOI: https://doi.org/10.1016/j.jacc.2006.08.042

Salzano A, Marra A., Ferrara F. Multiple hormone deficiency syndrome in heart failure with preserved ejection fraction. Int J Cardiol 2016;225:1-3. DOI: https://doi.org/10.1016/j.ijcard.2016.09.085

Bastenie PA, Vanhaelst L, Neve P. Coronary-artery disease in hypothyroidism. Lancet 1967;2:1221–2. DOI: https://doi.org/10.1016/S0140-6736(67)90562-4

Tanis BC, Westendorp GJ, Smelt HM. Effect of thyroid substitution on hypercholesterolaemia in patients with subclinical hypothyroidism: a reanalysis of intervention studies. Clin Endocrinol (Oxf) 1996;44:643–9. DOI: https://doi.org/10.1046/j.1365-2265.1996.739560.x

Wei JY, Genecin A, Greene HL, Achuff SC. Coronary spasm with ventricular fibrillation during thyrotoxicosis: response to attaining euthyroid state. Am J Cardiol 1979;43:335–9. DOI: https://doi.org/10.1016/S0002-9149(79)80023-5

Woeber KA. Thyrotoxicosis and the heart. N Engl J Med 1992;327:94–8. DOI: https://doi.org/10.1056/NEJM199207093270206

Siu C-W, Zhang X-H, Yung C, et al. Hemodynamic changes in hyperthyroidism-related pulmonary hypertension: a prospective echocardiographic study. J Clin Endocrinol Metab 2007;92:1736–42. DOI: https://doi.org/10.1210/jc.2006-1877

Sugiura T, Yamanaka S, Takeuchi H, et al. Autoimmunity and pulmonary hypertension in patients with Graves’ disease. Heart Vessels 2015;30:642–6. DOI: https://doi.org/10.1007/s00380-014-0518-3

Vallabhajosula S, Radhi S, Cevik C, et al. Hyperthyroidism and pulmonary hypertension: an important association. Am J Med Sci 2011;342:507–12. DOI: https://doi.org/10.1097/MAJ.0b013e31821790f4

Danzi S, Klein I. Thyroid disease and the cardiovascular system. Endocrinol Metab Clin North Am 2014;43:517–28. DOI: https://doi.org/10.1016/j.ecl.2014.02.005

Bielecka-Dabrowa A, Mikhailidis DP, Rysz J, Banach M. The mechanisms of atrial fibrillation in hyperthyroidism. Thyroid Res 2009;2:4. DOI: https://doi.org/10.1186/1756-6614-2-4

Forfar JC, Feek CM, Miller HC, Toft AD. Atrial fibrillation and isolated suppression of the pituitary-thyroid axis: response to specific antithyroid therapy. Int J Cardiol 1981;1:43–8. DOI: https://doi.org/10.1016/0167-5273(81)90047-4

Sawin CT, Geller A, Wolf PA, et al. Low serum thyrotropin concentrations as a risk factor for atrial fibrillation in older persons. N Engl J Med 1994;331:1249–52. DOI: https://doi.org/10.1056/NEJM199411103311901

Forfar JC, Miller HC, Toft AD. Occult thyrotoxicosis: a correctable cause of ‘idiopathic’ atrial fibrillation. Am J Cardiol 1979;44:9–12. DOI: https://doi.org/10.1016/0002-9149(79)90243-1

Vargas-Uricoechea H, Bonelo-Perdomo A, Sierra-Torres CH. Effects of thyroid hormones on the heart. Clin Investig Arterioscler 2014;26:296–309. DOI: https://doi.org/10.1016/j.arteri.2014.07.003

Tănase DM, Ionescu SD, Ouatu A, et al. Risk assessment in the development of atrial fibrillation at patients with associate thyroid dysfunctions. Rev Med Chir Soc Med Nat Iasi 2013;117:623-9.

Chaker L, Heeringa J, Dehghan A, et al. Normal thyroid function and the risk of atrial fibrillation: the Rotterdam study. J Clin Endocrinol Metab 2015;100:3718–24. DOI: https://doi.org/10.1210/jc.2015-2480

Staffurth JS, Gibberd MC, Fui SN. Arterial embolism in thyrotoxicosis with atrial fibrillation. Br Med J 1977;2:688–90. DOI: https://doi.org/10.1136/bmj.2.6088.688

Frost L, Vestergaard P, Mosekilde L. Hyperthyroidism and risk of atrial fibrillation or flutter: a population-based study. Arch Intern Med 2004;164:1675–8. DOI: https://doi.org/10.1001/archinte.164.15.1675

Elbers LPB, Fliers E, Cannegieter SC. The influence of thyroid function on the coagulation system and its clinical consequences. J Thromb Haemost 2018;16:634–45. DOI: https://doi.org/10.1111/jth.13970

Kellett HA, Sawers JS, Boulton FE, et al. Problems of anticoagulation with warfarin in hyperthyroidism. Q J Med 1986;58:43–51.

Goldstein SA, Green J, Huber K, et al. Characteristics and outcomes of atrial fibrillation in patients with thyroid disease (from the ARISTOTLE Trial). Am J Cardiol 2019;124:1406-12. DOI: https://doi.org/10.1016/j.amjcard.2019.07.046

Surks MI, Ortiz E, Daniels GH, et al. Subclinical thyroid disease: scientific review and guidelines for diagnosis and management. JAMA 2004;291:228–38. DOI: https://doi.org/10.1001/jama.291.2.228

Biondi B, Palmieri EA, Lombardi G, Fazio S. Effects of subclinical thyroid dysfunction on the heart. Ann Intern Med 2002;137:904–14. DOI: https://doi.org/10.7326/0003-4819-137-11-200212030-00011

Biondi B, Bartalena L, Cooper DS, et al. The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism. Eur Thyroid J 2015;4:149–63. DOI: https://doi.org/10.1159/000438750

Nanchen D, Gussekloo J, Westendorp RGJ, et al. Subclinical thyroid dysfunction and the risk of heart failure in older persons at high cardiovascular risk. J Clin Endocrinol Metab 2012;97:852–61. DOI: https://doi.org/10.1210/jc.2011-1978

Selmer C, Olesen JB, Hansen ML, et al. The spectrum of thyroid disease and risk of new onset atrial fibrillation: a large population cohort study. BMJ 2012;345:e7895. DOI: https://doi.org/10.1136/bmj.e7895

Selmer C, Olesen JB, Hansen ML, et al. Subclinical and overt thyroid dysfunction and risk of all-cause mortality and cardiovascular events: a large population study. J Clin Endocrinol Metab 2014;99:2372–82. DOI: https://doi.org/10.1210/jc.2013-4184

Spencer C, Eigen A, Shen D, et al. Specificity of sensitive assays of thyrotropin (TSH) used to screen for thyroid disease in hospitalized patients. Clin Chem 1987;33:1391–6. DOI: https://doi.org/10.1093/clinchem/33.8.1391

De Groot LJ. Dangerous dogmas in medicine: the nonthyroidal illness syndrome. J Clin Endocrinol Metab 1999;84:151–64. DOI: https://doi.org/10.1210/jcem.84.1.5364

Hamilton MA, Stevenson LW, Fonarow GC, et al. Safety and hemodynamic effects of intravenous triiodothyronine in advanced congestive heart failure. Am J Cardiol 1998;81:443-7. DOI: https://doi.org/10.1016/S0002-9149(97)00950-8

Bartalena L, Bogazzi F, Chiovato L, et al. 2018 European Thyroid Association (ETA) Guidelines for the Management of Amiodarone-Associated Thyroid Dysfunction. Eur Thyroid J 2018;7:55-66. DOI: https://doi.org/10.1159/000486957

Abbara A, Clarke SA, Brewster R, et al. pharmacodynamic response to anti-thyroid drugs in Graves' hyperthyroidism. Front Endocrinol (Lausanne) 2020;11:286. DOI: https://doi.org/10.3389/fendo.2020.00286

How to Cite



“Thyroid Dysfunction on the Heart: Clinical Effects, Prognostic Impact and Management Strategies”. 2022. Monaldi Archives for Chest Disease 92 (4). https://doi.org/10.4081/monaldi.2022.2145.