Document Detail


Thyroid hormone levels within reference range are associated with heart rate, cardiac structure, and function in middle-aged men and women.
MedLine Citation:
PMID:  23339744     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Triiodothyronine (T3) has many effects on the heart, and marked changes in cardiac function and structure occur in patients with (subclinical) thyroid disease. We investigated whether between-subject variation in thyroid hormone levels within the euthyroid range is also associated with heart rate and echocardiographic heart function and structure.
METHODS: Subjects were selected from the Asklepios study (n=2524), a population-representative random sample of patients aged between 35 and 55 years, free from overt cardiovascular disease at baseline. Analyses were restricted to 2078 subjects (1013 women and 1065 men), not using antihypertensive or thyroid medication nor having antithyroperoxidase antibody levels above clinical cut-off or thyrotropin (TSH) levels outside the reference range. All subjects were phenotyped in-depth and underwent comprehensive echocardiography, including diastolic evaluation. Thyroid function parameters were determined by automated electrochemiluminescence.
RESULTS: Heart rate was robustly positively associated with (quartiles of) free T3 (FT3) and T3, both in subjects with TSH levels within reference (0.27-4.2 μU/L) and in narrow TSH range (0.5-2.5 μU/L; p<0.0001). FT3 and T3 were negatively associated with left ventricular (LV) end-diastolic volume but positively associated with relative wall thickness. Total T3 (TT3) was associated with enhanced ventricular contraction (as assessed by tissue Doppler imaging). Free thyroxine, FT3, and TT3 were positively associated with late ventricular filling, and TT3 was associated with early ventricular filling.
CONCLUSION: We have demonstrated a strong positive association between thyroid hormone levels within the euthyroid range and heart rate, and more subtle effects on cardiac function and structure. More specifically, we suggest a smaller LV cavity size (with increased relative wall thickness), an enhanced atrial and ventricular contraction, and LV relaxation with higher circulating thyroid hormones. These results illustrate that variation in thyroid hormone levels, even within the reference range, exerts effects on the heart.
Authors:
Greet L Roef; Youri E Taes; Jean-Marc Kaufman; Caroline M Van Daele; Marc L De Buyzere; Thierry C Gillebert; Ernst R Rietzschel
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2013-07-17
Journal Detail:
Title:  Thyroid : official journal of the American Thyroid Association     Volume:  23     ISSN:  1557-9077     ISO Abbreviation:  Thyroid     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-08-22     Completed Date:  2014-03-10     Revised Date:  2014-08-05    
Medline Journal Info:
Nlm Unique ID:  9104317     Medline TA:  Thyroid     Country:  United States    
Other Details:
Languages:  eng     Pagination:  947-54     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Echocardiography
Female
Heart / anatomy & histology,  physiology*
Heart Rate / drug effects*
Heart Ventricles / physiopathology
Humans
Male
Middle Aged
Reference Values
Sex Factors
Thyroid Hormones / blood*
Thyrotropin / blood
Thyroxine / blood
Triiodothyronine / blood
Chemical
Reg. No./Substance:
0/Thyroid Hormones; 06LU7C9H1V/Triiodothyronine; 9002-71-5/Thyrotropin; Q51BO43MG4/Thyroxine
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