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High Time to Consider the Role of Thyroid Function in Single Ventricle Heart Disease

Dean S Karahalios1, Swati Sehgal2

  • 1Central Michigan University and Children's Hospital of Michigan, 3901 Beaubien Boulevard, Detroit, MI, 48201, USA. dkarahal@dmc.org.

Pediatric Cardiology
|June 5, 2023
PubMed

Insights

The US FDA recommends thyroid testing after iodinated contrast media exposure in children. For single ventricle heart disease patients, thyroid hormone

Area of Science:

  • Pediatric Cardiology
  • Endocrinology
  • Radiology

Background:

  • The United States Food and Drug Administration (FDA) issued a recommendation for thyroid function testing in children up to 3 years old within 3 weeks of exposure to iodinated contrast media (ICM).
  • Thyroid hormone significantly impacts the cardiovascular system, and patients with congenital heart disease have an elevated risk of thyroid disease.
  • The Fontan circulation, a surgical procedure for single ventricle heart disease, has hemodynamic consequences that may affect the thyroid gland.

Purpose of the Study:

  • To respond to the FDA's recommendation regarding thyroid function testing after ICM exposure in children.
  • To discuss the potential clinical significance of subclinical hypothyroidism in the context of cardiovascular health.
  • To emphasize the importance of considering cardiovascular effects of thyroid hormone in patients with single ventricle heart disease.

Main Methods:

  • This study presents a perspective and opinion based on existing knowledge.
  • It involves a critical review of the FDA's recommendation in relation to pediatric cardiovascular conditions.
  • The authors consider the interplay between thyroid function, cardiovascular health, and specific patient populations.

Main Results:

  • The authors argue that the cardiovascular effects of thyroid hormone may be particularly influential in patients with single ventricle heart disease.
  • The FDA's recommendation prompts consideration for routine thyroid hormone surveillance in this specific patient group.
  • Subclinical hypothyroidism could have significant clinical implications for these vulnerable patients.

Conclusions:

  • The FDA's recommendation highlights the need for careful consideration of thyroid function testing in children exposed to ICM.
  • Routine thyroid hormone surveillance should be considered in the long-term management of patients with single ventricle heart disease.
  • This approach may help mitigate potential cardiovascular complications associated with thyroid dysfunction in this population.

Keywords:
FontanSingle ventricleThyroid disease

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