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Thyroid hormones and heart failure
1DAMIC/Fundación Rusculleda, Cordoba National University, Av. Colon 2057, Córdoba, 5000, Argentina. dr.martinez@usa.net.
Insights
Thyroid dysfunction significantly impacts heart failure (HF) risk and outcomes. Both thyroid hormones and TSH levels are crucial for cardiac health, influencing diagnosis and treatment strategies.
Area of Science:
- Endocrinology and Cardiology
- Investigates the intricate relationship between thyroid function and cardiovascular health.
Background:
- Heart failure (HF) is a prevalent health issue with growing evidence linking it to thyroid dysfunction.
- Thyroid hormones (TH), particularly T3, possess cardioprotective properties.
- Thyroid disorders can precipitate cardiac dysfunction, and conversely, cardiac issues can lead to thyroid dysregulation.
Purpose of the Study:
- To explore the bidirectional relationship between thyroid dysfunction and heart failure.
- To highlight the clinical implications of thyroid hormone levels and TSH in HF management.
- To emphasize the role of thyroid status in predicting HF outcomes.
Main Methods:
- Review of recent studies investigating thyroid dysfunction in heart failure patients.
- Analysis of the impact of altered thyroid hormone levels on cardiac function.
- Examination of TSH as a predictor of clinical outcomes in HF.
Main Results:
- Increased plasma TH can lead to negative neurohormonal activation impacting cardiac function.
- Hypothyroidism is associated with altered myocardial and vascular remodeling, contributing to cardiac failure.
- Low plasma TSH levels are identified as an independent risk factor for HF development and adverse clinical outcomes, including mortality and hospitalizations.
Conclusions:
- Thyroid dysfunction plays a significant role in the pathophysiology and prognosis of heart failure.
- Physicians must consider thyroid status for accurate diagnosis and effective treatment of HF patients.
- TSH levels are important predictors of clinical outcomes in heart failure.
Abstract:
Heart failure is a major health problem and its relationship to thyroid dysfunction has been increasingly investigated in recent years. Since it has been demonstrated that thyroid hormones (TH) and mainly T3 have cardioprotective effects, it is easy to understand that in the scenario of thyroid disorder, cardiac function may be damaged, and inversely in cardiac dysfunction thyroid dysregulation may be seen. The increase in plasma TH produces a clear neurohormonal activation which impacts negatively on cardiac function. In hypothyroidism, and in addition to extracardiac dysfunction, myocardial and vascular remodelling is altered and they contribute to cardiac failure. Abnormal low plasma TSH has also been shown to be a risk factor for developing HF in several recent studies, and they suggest that TSH is an independent predictor of clinical outcome including death and cardiac hospitalizations. Therefore, physicians should consider all these concepts when managing a patient with heart failure, not only for a clear diagnosis, but also for better and accurate treatment.
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