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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:  Publisher    
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 between 35 and 55 yrs, 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 anti-TPO levels above clinical cut-off or 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) (F)T3, both in subjects with TSH levels within reference (0.27-4.2 µU/l) as in narrow TSH-range (0.5-2.5 µU/l) (p≤0.0001). (F)T3 was negatively associated with LV (left ventricular) end-diastolic volume but positively with relative wall thickness. TT3 was associated with enhanced ventricular contraction (as assessed by tissue Doppler imaging). FT4, 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 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 of thyroid hormone levels even within the reference range exerts effects on the heart.
Greet Leen Roef; Youri E Taes; Jean-Marc Kaufman; Caroline Van Daele; Marc L De Buyzere; Thierry C Gillebert; Ernst R Rietzschel
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-22
Journal Detail:
Title:  Thyroid : official journal of the American Thyroid Association     Volume:  -     ISSN:  1557-9077     ISO Abbreviation:  Thyroid     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9104317     Medline TA:  Thyroid     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Ghent University Hospital, Endocrinology, De Pintelaan 185, 9000 Gent, Gent, Belgium, 9000, ++3293325595;
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