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Rethinking strategies for solving thyroid dysfunction at the heart of cardiovascular disease.

Viswanathan Rajagopalan1, Kaie Ojamaa2, A Martin Gerdes2

  • 1New York Institute of Technology College of Osteopathic Medicine at A- State, Jonesboro, AR, United States of America. vrajagop@nyit.edu.

Molecular Medicine (Cambridge, Mass.)
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Summary

Thyroid hormones (THs) impact cardiovascular health throughout life. This review explores TH therapy for heart failure (HF), suggesting new strategies and biomarkers like brain natriuretic peptide (BNP) for improved patient management.

Keywords:
Acute coronary syndromesBNPBiomarkersHeart failureT3T4Thyroid hormonesThyroxineTriiodothyronine

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Area of Science:

  • Cardiovascular Endocrinology
  • Thyroid Hormone Physiology
  • Heart Failure Pathophysiology

Background:

  • Thyroid hormones (THs) are critical for cardiovascular health from development to adult function.
  • Dysfunctional thyroid status, often low or borderline-low TH levels, is common in moderate to severe heart failure (HF).
  • Maintaining hypothalamic-thyroid axis integrity is vital for preventing cardiac and all-cause mortality.

Purpose of the Study:

  • To review the potential of thyroid hormone (TH) therapy in managing heart failure (HF).
  • To highlight recent clinical study outcomes regarding TH therapy in HF.
  • To discuss the need for biomarkers correlating with cardiac TH status, such as brain natriuretic peptide (BNP).

Main Methods:

  • Review of recent clinical studies on TH therapy in heart failure (HF) patients.
  • Analysis of the correlation between serum biomarkers (e.g., BNP) and cardiac tissue TH status.
  • Exploration of novel therapeutic strategies for HF management involving THs.

Main Results:

  • Low or borderline-low thyroid hormone function is prevalent in moderate to severe heart failure (HF).
  • Recent studies provide insights into the outcomes of TH therapy in HF patients.
  • Brain natriuretic peptide (BNP) is identified as a potential biomarker for HF stage and TH status.

Conclusions:

  • Thyroid hormone (TH) therapy holds potential for advancing heart failure (HF) management.
  • Reassessing normal thyroid status in HF patients is necessary for effective treatment.
  • Combination therapies and biomarker-guided approaches may improve outcomes for HF patients with thyroid dysfunction.