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Thyroid Hormones-An Underestimated Player in Dilated Cardiomyopathy?

Karolina Zawadzka1, Radosław Dziedzic1, Andrzej Surdacki2

  • 1Students' Scientific Group at the Second Department of Cardiology, Jagiellonian University Medical College, 2 Jakubowskiego Street, 30-688 Cracow, Poland.

Journal of Clinical Medicine
|August 27, 2021
PubMed

Insights

Dilated cardiomyopathy patients often have low thyroid hormone (T3) levels, impacting prognosis. This review explores thyroid hormone status, myocardial gene expression, and potential T3 therapy for DCM treatment.

Area of Science:

  • Cardiology
  • Endocrinology
  • Molecular Biology

Background:

  • Dilated cardiomyopathy (DCM) is a primary heart muscle disease characterized by left ventricular dilation and impaired function.
  • Altered thyroid status, particularly low free triiodothyronine (T3) and elevated thyroid-stimulating hormone, is common in DCM patients.
  • Subtle thyroid dysfunction, especially low T3, correlates with poorer prognosis and increased mortality in DCM.

Purpose of the Study:

  • To review current understanding of thyroid hormone (TH) status and its link to prognosis in DCM.
  • To discuss the abnormal expression of genes involved in myocardial TH synthesis within DCM.
  • To explore the potential therapeutic role of THs in managing DCM.

Main Methods:

  • Literature review of studies on thyroid hormone status in DCM.
  • Analysis of research on myocardial gene expression related to TH biosynthesis and metabolism.
  • Synthesis of evidence regarding the efficacy of TH therapy in DCM.

Main Results:

  • DCM patients frequently exhibit low T3 levels, associated with worse outcomes.
  • Evidence suggests impaired local TH bioavailability in the myocardium of DCM patients.
  • Genes for TH biosynthesis are expressed in the DCM myocardium, indicating local regulatory roles.

Conclusions:

  • Thyroid hormone status is a critical prognostic factor in DCM.
  • Local myocardial TH synthesis and metabolism are altered in DCM.
  • Thyroid hormone therapy presents a potential future treatment strategy for DCM.

Keywords:
dilated cardiomyopathyprognosisthyroid hormonesthyroid statustreatment

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