Skip to main content

Advertisement

Log in

Thyroid hormone and cardiovascular system: from basic concepts to clinical application

  • Review
  • Published:
Internal and Emergency Medicine Aims and scope Submit manuscript

Abstract

Experimental and clinical findings strongly support the concept that thyroid hormone (TH) plays a fundamental role in the cardiovascular (CV) homeostasis. CV diseases represent a major public health care and economic problem being one of the principal causes of morbility, mortality and hospitalization. In particular, chronic heart failure (HF) is one of the most common reasons for general practitioners consultations in people >65–70 years old. TH derangement may have a key role in the evolution process of HF. In HF, the main and earlier alteration of the thyroid function is referred to as “low-T3” syndrome characterized by the reduction in serum total T3 and free T3 with normal levels of thyroxine (T4) and thyrotropin (TSH). This syndrome may affect till one-third of advanced HF patients. The main goal of this mini-review is to examine the main pathophysiological and clinical links between an altered thyroid metabolism and CV diseases, namely HF during progression of disease from organ specific to systemic disorder.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Klein I, Ojamaa K (2001) Mechanisms of disease: thyroid hormone and the cardiovascular system. New Engl J Med 344:501–509

    Article  PubMed  CAS  Google Scholar 

  2. Gerdes AM, Iervasi G (2010) Thyroid replacement therapy and heart failure. Circulation 122:385–393. doi:10.1161/CIRCULATIONAHA.109.917922

    Article  PubMed  Google Scholar 

  3. Colantuoni A, Marchiafava PL, Lapi D, Forini FS, Iervasi G (2005) Effects of tetraiodothyronine and triiodothyronine on hamster cheek pouch microcirculation. Am J Physiol Heart Circ Physiol 288:H1931–H1936. doi:10.1152/ajpheart.00931.2004

    Article  PubMed  CAS  Google Scholar 

  4. Galli E, Pingitore A, Iervasi G (2010) Thyroid hormone in the pathophysiology of heart failure: clinical evidence. Heart Fail Rev 15:155–169. doi:10.1007/s10741-008-9126-6

    Article  PubMed  CAS  Google Scholar 

  5. Mizuma H, Murakami M, Mori M (2001) Thyroid hormone activation in human vascular smooth muscle cells—expression of type II iodothyronine deiodinase. Circulation Research 88:313–318. doi:10.1161/01.RES.88.3.313

    Google Scholar 

  6. Mourouzis I, Forini F, Pantos C, Iervasi G (2011) Thyroid hormone and cardiac disease: from basic concepts to clinical application. J Thyroid Res 958626. doi:10.4061/2011/958626

  7. Pingitore A, Landi P, Taddei MC, Ripoli A, L’Abbate A, Iervasi G (2005) Triiodothyronine levels for risk stratification of patients with chronic heart failure. Am J Med 118:132–136. doi:10.1016/j.amjmed.2004.07.052

    Article  PubMed  CAS  Google Scholar 

  8. Iervasi G, Molinaro S, Landi P, Taddei MC, Galli E, Mariani F, L’Abbate A, Pingitore A (2007) Association between increased mortality and mild thyroid dysfunction in cardiac patients. Arch Intern Med 167:1526–1532. doi:10.1001/archinte.167.14.1526

    Article  PubMed  Google Scholar 

  9. Rodondi N, den Elzen WP, Bauer DC, Cappola AR, Razvi S, Walsh JP, Asvold BO, Iervasi G, Imaizumi M, Collet TH, Bremner A, Maisonneuve P, Sgarbi JA, Khaw KT, Vanderpump MP, Newman AB, Cornuz J, Franklyn JA, Westendorp RG, Vittinghoff E, Gussekloo J (2010) Thyroid Studies Collaboration. Subclinical hypothyroidism and the risk of coronary heart disease and mortality. JAMA 304(12):1365–1374. doi:10.1001/jama.2010.1361

  10. Collet TH, Gussekloo J, Bauer DC, den Elzen WP, Cappola AR, Balmer P, Iervasi G, Åsvold BO, Sgarbi JA, Völzke H, Gencer B, Maciel RM, Molinaro S, Bremner A, Luben RN, Maisonneuve P, Cornuz J, Newman AB, Khaw KT, Westendorp RG, Franklyn JA, Vittinghoff E, Walsh JP, Rodondi N (2012) Thyroid Studies Collaboration. Subclinical hyperthyroidism and the risk of coronary heart disease and mortality. Arch Int Med 172:799–809. doi:10.1001/archinternmed.2012.402

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Giorgio Iervasi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Iervasi, G., Nicolini, G. Thyroid hormone and cardiovascular system: from basic concepts to clinical application. Intern Emerg Med 8 (Suppl 1), 71–74 (2013). https://doi.org/10.1007/s11739-013-0911-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11739-013-0911-4

Keywords

Navigation