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Thyroid hormone therapy in cardiovascular disease
J D Klemperer1, K Ojamaa, I Klein
1Department of Medicine, North Shore University Hospital, Cornell University Medical College, Manhasset, NY 11030, USA.
Abstract:
The relationship between thyroid disease states and cardiovascular hemodynamics is well recognized. Although the long-term effects of thyroid hormone are thought to result from changes in myocardial gene expression, attention has recently focused on acute, non-nuclear-mediated actions of L-triidothyronine (T3), the biologically active form of the hormone. Various lines of evidence have documented that T3 can act as a vasodilator and inotrope. With this recognition have come novel treatment strategies targeted at specific clinical conditions including heart failure and cardiac surgery that are associated with impaired cardiovascular performance and low serum T3 levels. An understanding of the mechanisms of action of thyroid hormone on the heart and peripheral vasculature is essential for the rational implementation of thyroid hormone as a therapeutic agent. As outlined in this review, initial clinical experience suggests that the ability of thyroid hormone to increase cardiac output and to lower systemic vascular resistance may provide a novel treatment option for physicians caring for patients with cardiovascular illness.
Insights
Thyroid hormone (T3) has acute, non-nuclear effects on the cardiovascular system, acting as a vasodilator and inotrope. This offers potential new treatments for heart failure and cardiac surgery patients with low T3 levels.
Area of Science:
- Cardiology
- Endocrinology
- Molecular Medicine
Background:
- Thyroid disease significantly impacts cardiovascular hemodynamics.
- Long-term thyroid hormone effects are linked to myocardial gene expression.
- Recent research highlights acute, non-nuclear actions of L-triiodothyronine (T3).
Purpose of the Study:
- To review the acute, non-nuclear mechanisms of thyroid hormone action on the cardiovascular system.
- To explore novel therapeutic strategies utilizing thyroid hormone for cardiovascular conditions.
- To understand thyroid hormone's role in heart failure and cardiac surgery.
Main Methods:
- Review of existing scientific literature and clinical data.
- Analysis of evidence for T3's vasodilatory and inotropic properties.
- Examination of clinical outcomes in patients with impaired cardiovascular performance and low T3.
Main Results:
- L-triiodothyronine (T3) demonstrates acute vasodilatory and inotropic effects.
- Thyroid hormone can increase cardiac output and decrease systemic vascular resistance.
- Initial clinical data suggest therapeutic potential in cardiovascular illness.
Conclusions:
- Acute actions of thyroid hormone offer novel therapeutic avenues.
- Understanding T3's mechanisms is crucial for cardiovascular treatment.
- Thyroid hormone may be a valuable option for managing cardiovascular diseases.