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Thyroid hormones and the heart

  • Hernando Vargas-Uricoechea EMAIL logo and Carlos Hernán Sierra-Torres
Published/Copyright: January 14, 2014
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Hormone Molecular Biology and Clinical Investigation
From the journal Hormone Molecular Biology and Clinical Investigation Volume 18 Issue 1

Abstract

Thyroid hormones have a significant impact on heart function, mediated by genomic and non-genomic effects. Consequently, thyroid hormones deficit as well as excess are expected to result in profound changes in cardiac function regulation and cardiovascular hemodynamics. Thyroid hormones upregulate the expression of the sarcoplasmic reticulum calcium-activated ATPase and downregulate the expression of phospholamban. Overall, hyperthyroidism is characterized by an increase in resting heart rate, blood volume, stroke volume, myocardial contractility, and ejection fraction. The development of “high-output heart failure” in hyperthyroidism may be due to “tachycardia-mediated cardiomyopathy.” In contrast, in the hypothyroid state, thyroid hormone deficiency results in lower heart rate and weakening of myocardial contraction and relaxation, with prolonged systolic and early diastolic times. Cardiac preload is decreased owing to impaired diastolic function, cardiac afterload is increased, and chronotropic and inotropic functions are reduced. Subclinical thyroid dysfunction is relatively common in patients >65 years of age. In general, subclinical hypothyroidism increases the risk of cardiovascular heart disease (CHD) mortality and CHD events, but not of total mortality. The risk of CHD mortality and atrial fibrillation (but not other outcomes) in subclinical hyperthyroidism is higher among patients with very low levels of thyrotropin. Finally, medications such as amiodarone may induce hypothyroidism (mediated by the Wolff-Chaikoff effect) as well as hyperthyroidism (mediated by the Jod-Basedow effect). In both instances, the underlying cause is the high concentration of iodine in this medication. The purpose of this review is to assess the effects of thyroid hormones on the heart, and their clinical repercussions.

Keywords: amiodarone; cardiovascular; fibrillation; heart; hyperthyroidism; hypothyroidism; subclinical dysfunction; thyroid hormones
Corresponding author: Hernando Vargas-Uricoechea, Departamento de Medicina Interna, Hospital Universitario, San José, Carrera 6 No 10N-142 3er piso, Phone: +8234508, Fax: +8234712, E-mail:

Conflict of interest statement

Authors’ conflict of interest disclosure: The authors declare that there is no conflict of interest that could bias the impartiality of this review.

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Received: 2013-10-4
Accepted: 2013-11-20
Published Online: 2014-1-14
Published in Print: 2014-4-1

©2014 by De Gruyter

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. The endocrine and cardiovascular systems: a close liaison
  4. Review Articles
  5. Leptin, a mediator of cardiac damage associated with obesity
  6. Thyroid hormones and the heart
  7. Effects of hormones on platelet aggregation
  8. The role of leptin/adiponectin ratio in metabolic syndrome and diabetes
  9. Circadian rhythm, sleep pattern, and metabolic consequences: an overview on cardiovascular risk factors
https://doi.org/10.1515/hmbci-2013-0059
Keywords for this article
amiodarone; cardiovascular; fibrillation; heart; hyperthyroidism; hypothyroidism; subclinical dysfunction; thyroid hormones

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. The endocrine and cardiovascular systems: a close liaison
  4. Review Articles
  5. Leptin, a mediator of cardiac damage associated with obesity
  6. Thyroid hormones and the heart
  7. Effects of hormones on platelet aggregation
  8. The role of leptin/adiponectin ratio in metabolic syndrome and diabetes
  9. Circadian rhythm, sleep pattern, and metabolic consequences: an overview on cardiovascular risk factors
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