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Thyroid Function and Effects on Cardiovascular System

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Thyroid, Obesity and Metabolism

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Abstract

The action of thyroid hormone (TH) is effective in a pleiotropic manner on a large number of organs and tissues. TH receptors are present in the myocardium and vascular tissue, playing an important role in the regulation of certain molecular pathways present in the heart and cardiovascular system (genomic mechanisms).

Triiodothyronine, the active TH, is able to bind nuclear TH receptors (TRs), regulating the transcription of specific target gene expression, ion channels (Na+/K+-activated ATPase, Na+/Ca++ exchanger) and cell surface receptors that, in turn, determine physiologic effects on the cardiovascular system such as decline in systemic vascular resistance, increase in cardiac output and cardiac contractility. In addition to these genomic effects, TH produces changes in cardiac inotropism and chronotropism by regulating the vagal and adrenergic tone (non-genomic mechanisms). The increase or decrease in blood concentration of TH causes relevant cardiovascular derangements. It is well known that overt hyperthyroidism (OHyper) is associated with increase of heart rate, enhanced left ventricular systolic and diastolic function, whereas overt hypothyroidism (OHypo) is characterized by the opposite changes with a consequent worsening of atherosclerotic risk factors, including hypercholesterolemia, diastolic hypertension, and carotid intimal-media thickness. Subclinical hypothyroidism (SHypo) is associated with endothelial dysfunctions and cardiovascular risk increase.

Cardiological dysfunctions also affect an alteration of the concentration of TH (namely low triiodothyronine syndrome), leading to increased risk of morbidity and mortality. The aim of this chapter is to provide an overview of TH effects on the cardiovascular system, their clinical correlates, and also to understand the potential benefit of TH treatment in patients with cardiovascular diseases.

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Authors and Affiliations

  1. Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy

    Cesare C. F. Berra

  2. Diabetology and Endocrine Disease Unit, IRCCS Multimedica, Sesto S. Giovanni, Milan, Italy

    Mariluce Barrasso

Authors
  1. Cesare C. F. Berra
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  2. Mariluce Barrasso
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Correspondence to Cesare C. F. Berra .

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  1. Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Sesto San Giovanni and Ospedale San Giuseppe, Milano, Italy

    Livio Luzi

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Berra, C.C.F., Barrasso, M. (2021). Thyroid Function and Effects on Cardiovascular System. In: Luzi, L. (eds) Thyroid, Obesity and Metabolism. Springer, Cham. https://doi.org/10.1007/978-3-030-80267-7_13

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  • DOI: https://doi.org/10.1007/978-3-030-80267-7_13

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