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

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.