Skip to main content
SpringerLink
Log in

Association of left ventricular hypertrophy with the level of thyroid hormone in euthyroid state

  • Original Article
  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

Purpose

It has been demonstrated that variation in thyroid hormone levels even within normal range was associated with increased cardiovascular risk. However, available data are still insufficient on association between left ventricular hypertrophy (LVH) and thyroid hormone levels within euthyroid state.

Methods

In 69,298 Koreans with euthyroid function, we evaluated association between echocardiographically detected LVH and thyroid hormone levels within the normal range. Study participants were categorized into elderly (age ≥ 40) and younger (age < 40) groups, where subjects were divided into four groups according to quartile levels of thyroxine (FT4), triiodothyronine (FT3), and thyroid-stimulating hormone (TSH). Multivariable adjusted logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence interval (CI) for LVH (adjusted ORs [95% CI]) across quartile levels of thyroid hormones.

Results

In elderly group, adjusted ORs for LVH generally higher in the first quartile group than other quartile groups, despite no statistical significance in some cases (first quartile: reference, second quartile: 0.86 [0.67–1.11] in TSH, 0.75 [0.58–0.95] in FT4 and 0.63 [0.49–0.81] in FT3, third quartile: 0.70 [0.54–0.92] in TSH, 0.79 [0.61–1.02] in FT4 and 0.72 [0.55–0.93] in FT3, fourth quartile: 0.81 [0.65–1.04] in TSH, 0.85 [0.65–1.10] in FT4 and 0.58 [0.44–0.77] in FT3). This finding was similarly found in the younger group, despite discrepancy in some cases.

Conclusion

In euthyroid state, low normal levels in FT4, FT3 and TSH were more strongly associated with LVH.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Klein I, Danzi S (2007) Thyroid disease and the heart. Circulation 116:1725–1735

    Article  Google Scholar 

  2. Dillmann WH (2002) Cellular action of thyroid hormone on the heart. Thyroid 12(6):447–452

    Article  CAS  Google Scholar 

  3. Kelin I, Ojamaa K (2001) Thyroid hormone and the cardiovascular system. N Engl J Med 344:501–509

    Article  Google Scholar 

  4. Razvi S, Jabbar A, Pingitore A, Danzi S, Biondi B, Klein I, Peeters R, Zaman A, Iervasi G (2018) Thyroid hormones and cardiovascular function and diseases. J Am Coll Cardiol. 71:1781–1796

    Article  CAS  Google Scholar 

  5. Bengel FM, Nekolla SG, Ibrahim T, Weniger C, Ziegler SI, Schwaiger M (2000) Effect of thyroid hormones on cardiac function, geometry, and oxidative metabolism assessed noninvasively by positron emission tomography and magnetic resonance imaging. J Clin Endocrinol Metab 85:1822–1827

    Article  CAS  Google Scholar 

  6. Kahaly G, Mohr-Kahaly S, Beyer J, Meyer J (1995) Left ventricular function analyzed by Doppler and echocardiographic methods in short-term hypothyroidism. Am J Cardiol 75:645–648

    Article  CAS  Google Scholar 

  7. Dorr M, Wolff B, Robinson DM, John U, Ludemann J, Meng W, Felix SB, Volzke H (2005) The association of thyroid function with cardiac mass and left ventricular hypertrophy. J Clin Endocrinol Metab 90:673–677

    Article  Google Scholar 

  8. Auer J, Berent R, Weber T, Lassnig E, Eber B (2003) Thyroid function is associated with presence and severity of coronary atherosclerosis. Clin Cardiol 26:569–573

    Article  CAS  Google Scholar 

  9. Zhang Y, Kim BK, Chang Y, Ryu S, Cho J, Lee WY, Rhee EJ, Kwon MJ, Rampal S, Zhao D, Pastor-Barriuso R, Lima JA, Shin H, Guallar E (2014) Thyroid hormones and coronary artery calcification in euthyroid men and women. Arterioscler Thromb Vasc Biol 34:2128–2134

    Article  CAS  Google Scholar 

  10. Dullaart RP, de Vries R, Roozendaal C, Kobold AC, Sluiter WJ (2007) Carotid artery intima media thickness is inversely related to serum free thyroxine in euthyroid subjects. Clin Endocrinol 67:668–673

    Article  CAS  Google Scholar 

  11. Takamura N, Akilzhanova A, Hayashida N, Kadota K, Yamasaki H, Usa T, Nakazato M, Maeda T, Ozono Y, Aoyagi K (2009) Thyroid function is associated with carotid intima-media thickness in euthyroid subjects. Atherosclerosis 204:e77–e81

    Article  CAS  Google Scholar 

  12. Lorell BH, Carabello BA (2000) Left ventricular hypertrophy: pathogenesis, detection, and prognosis. Circulation 102:470–479

    Article  CAS  Google Scholar 

  13. Stevens SM, Reinier K, Chugh SS (2013) Increased left ventricular mass as a predictor of sudden cardiac death: is it time to put it to the test? Circ Arrhythm Electrophysiol 6:212–217

    Article  Google Scholar 

  14. Brown DW, Giles WH, Croft JB (2000) Left ventricular hypertrophy as a predictor of coronary heart disease mortality and the effect of hypertension. Am Heart J. 140:848–856

    Article  CAS  Google Scholar 

  15. Borhani NO (1987) Left ventricular hypertrophy, arrhythmias and sudden death in systemic hypertension. Am J Cardiol 60:13I–18I

    Article  CAS  Google Scholar 

  16. American Diabetes Association (2016) Standard of Medical Care in Diabetes. Diabetes Care 39(Suppl. 1):S13–S22

    Google Scholar 

  17. Kim JS, Zhang Y, Chang Y, Ryu S, Guallar E, Shin YC, Shin H, Lim SW, Cho J (2018) Subclinical hypothyroidism and incident depression in young and middle-age adults. J Clin Endocrinol Metab 103(5):1827–1833

    Article  Google Scholar 

  18. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise J, Solomon S, Spencer KT, St John Sutton M, Stewart W, American Society of Echocardiography's Nomenclature, and Standards Committee, Task Force on Chamber Quantification, American College of Cardiology Echocardiography Committee, American Heart Association, European Association of Echocardiography, European Society of Cardiology (2006) Recommendations for chamber quantification. Eur J Echocardiogr 7:79–108

    Article  Google Scholar 

  19. Park SK, Moon K, Ryoo JH, Oh CM, Choi JM, Kang JG, Chung JY, Young JJ (2018) The association between alcohol consumption and left ventricular diastolic function and geometry change in general Korean population. Eur Heart J Cardiovasc Imaging 19:271–278

    Article  Google Scholar 

  20. Houghton JL, Strogatz DS, Torosoff MT, Smith VE, Fein SA, Kuhner PA, Philbin EF, Carr AA (2003) African Americans with LVH demonstrate depressed sensitivity of the coronary microcirculation to stimulated relaxation. Hypertension 42:269–276

    Article  CAS  Google Scholar 

  21. Nadar SK, Blann AD, Kamath S, Beevers DG, Lip GY (2004) Platelet indexes in relation to target organ damage in high-risk hypertensive patients: a substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). J Am Coll Cardiol 44:415–422

    Article  Google Scholar 

  22. Devereux RB, Drayer JI, Chien S, Pickering TG, Letcher RL, DeYoung JL, Sealey JE, Laragh JH (1984) Whole blood viscosity as a determinant of cardiac hypertrophy in systemic hypertension. Am J Cardiol 54:592–595

    Article  CAS  Google Scholar 

  23. Lip GY, Blann AD, Jones AF, Lip PL, Beevers DG (1997) Relation of endothelium, thrombogenesis, and hemorheology in systemic hypertension to ethnicity and left ventricular hypertrophy. Am J Cardiol 80:1566–1571

    Article  CAS  Google Scholar 

  24. Park CW, Shin YS, Kim CM, Lee SY, Yu SE, Kim SY, Choi EJ, Chang YS, Bang BK (2002) Increased C-reactive protein following hemodialysis predicts cardiac hypertrophy in chronic hemodialysis patients. Am J Kidney Dis 40:1230–1239

    Article  CAS  Google Scholar 

  25. Castellon X, Bogdanova V (2016) Chronic inflammatory diseases and endothelial dysfunction. Aging Dis 7:81–89

    Article  Google Scholar 

  26. Taylor PN, Razvi S, Pearce SH, Dayan CM (2013) Clinical review: a review of the clinical consequences of variation in thyroid function within the reference range. J Clin Endocrinol Metab 98:3562–3571

    Article  CAS  Google Scholar 

  27. Chaker L, Baumgartner C, den Elzen WP, Collet TH, Ikram MA, Blum MR, Dehghan A, Drechsler C, Luben RN, Portegies ML, Iervasi G, Medici M, Stott DJ, Dullaart RP, Ford I, Bremner A, Newman AB, Wanner C, Sgarbi JA, Dörr M, Longstreth WT Jr, Psaty BM, Ferrucci L, Maciel RM, Westendorp RG, Jukema JW, Ceresini G, Imaizumi M, Hofman A, Bakker SJ, Franklyn JA, Khaw KT, Bauer DC, Walsh JP, Razvi S, Gussekloo J, Völzke H, Franco OH, Cappola AR, Rodondi N, Peeters RP, Thyroid Studies Collaboration (2016) Thyroid function within the reference range. J Clin Endocrinol Metab 101:4270–4282

    Article  CAS  Google Scholar 

  28. Cappola AR, Arnold AM, Wulczyn K, Carlson M, Robbins J, Psaty BM (2015) Thyroid function in the euthyroid range and adverse outcomes in older adults. J Clin Endocrinol Metab 100:1088–1096

    Article  CAS  Google Scholar 

  29. Shirani J, Barron M, Pierre-Louise M, Roberts W (1993) Congestive heart failure, dilated cardiac ventricles, and sudden death in hyperthyroidism. Am J Cardiol 72:365–368

    Article  CAS  Google Scholar 

  30. Kinugawa K, Yonekura K, Ribeiro RC, Eto Y, Aoyagi T, Baxter JD, Camacho SA, Bristow MR, Long CS, Simpson PC (2001) Regulation of thyroid hormone receptor isoforms in physiological and pathological cardiac hypertrophy. Circ Res 89:591–598

    Article  CAS  Google Scholar 

  31. Dörr M, Wolff B, Robinson DM, John U, Lüdemann J, Meng W, Felix SB, Völzke H (2005) The association of thyroid function with cardiac mass and left ventricular hypertrophy. J Clin Endocrinol Metab 90:673–677

    Article  Google Scholar 

  32. Fontes R, Coeli CR, Aguiar F, Vaisman M (2013) Reference interval of thyroid stimulating hormone and free thyroxine in a reference population over 60 years old and in very old subjects (over 80 years): comparison to young subjects. Thyroid Res 6:13

    Article  Google Scholar 

Download references

Acknowledgement

This study was based on medical data collected and arranged by Kangbuk Samsung Cohort Study (KSCS). Therefore, this study could be done by virtue of the labor of all staffs working in KSCS and Total Healthcare Center, Kangbuk Samsung Hospital.

Author information

Authors and Affiliations

  1. Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    S. K. Park

  2. Department of Occupational and Environmental Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea

    Jae-Hong Ryoo

  3. Total Healthcare Center, KangBuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea

    J. G. Kang & J. Y. Jung

  4. School of Medicine, Sungkyunkwan University, Seoul, Korea

    J. Y. Jung

Authors
  1. S. K. Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jae-Hong Ryoo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. G. Kang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Y. Jung
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

SKP coordinated the study, analyzed the data and wrote the manuscript as a first author. JGK verified the data on echocardiographic parameters as a cardiologist. J-HR played role in analyzing data and editing English grammar. JYY is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Corresponding author

Correspondence to J. Y. Jung.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Ethics approvals for the study protocol and analysis of the data were obtained from institutional review board of Kangbuk Samsung Hospital.

Informed consent

Informed consent was not required because we only assessed retrospective data without presonal identifying information.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 24 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Park, S.K., Ryoo, JH., Kang, J.G. et al. Association of left ventricular hypertrophy with the level of thyroid hormone in euthyroid state. J Endocrinol Invest 44, 111–117 (2021). https://doi.org/10.1007/s40618-020-01277-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40618-020-01277-7

Keywords

Search

Navigation