INFLUENCE OF AUTOIMMUNE THYROIDITIS ON THE CARDIOVASCULAR SYSTEM (LITERATURE REVIEW AND OWN DATA)
DOI:
https://doi.org/10.11603/1811-2471.2021.v.i2.12222Keywords:
AIT, effects on the cardiovascular system, changes in blood pressure, structure of the left ventricle, diastolic dysfunctionAbstract
Decreased hormonal function of the thyroid gland – hypothyroidism is one of the main and dangerous complications of autoimmune thyroiditis (AIT) for the body. One of the leading negative effects of hypothyroidism on the body is the high risk of cardiovascular disease.
The aim – to study the effect of AIT with unchanged thyroid function and in cases of moderate hypothyroidism on blood pressure and heart structure.
Material and Methods. 78 patients with AIT and 27 healthy controls were examined. Studied the hormonal function of the thyroid gland, anatomical features and functions of the heart muscle according to the data of echocardioscopy and blood pressure indicators.
Results. In patients with AIT, the diastolic pressure in comparison with the control group is determined significantly higher. Significant and reliable changes in the structure and function of the left ventricle were established, which, taking into account blood pressure indicators, can be regarded as manifestations of diastolic hypertension. Its manifestations are indicated by an increase in muscle mass and muscle mass index of the left ventricle, the thickness of the interventricular septum. At the same time, a decrease in the ejection fraction is noted.
Conclusions. In patients with AIT compared with healthy ones, the structure and function of the left ventricle is impaired. These changes are significant in all cases of AIT, however, they are more pronounced and significant in AIT with moderate hypothyresis. The effects of AIT on the heart and CVS are not fully understood. The mechanisms of development of diastolic hypertension in AIT, its prevention and treatment, especially in cases with euthyroid function of the thyroid gland, deserve attention.
References
Smith, T.J., Bahn, R.S., & Gorman, C.A. (1989). Connective tissue, glycosaminoglycans, and diseases of the thyroid. Endocr. Rev., 10 (3), 366-391. DOI: 10.1210/edrv-10-3-366
Devdhar, M., Ousman, Y.H., & Burman, K.D. (2007). Hypothyroidism. Endocrinol. Metab. Clin. North Am., 36 (3), 595-615. DOI: 10.1016/j.ecl.2007.04.008
Akamizu, T., & Amino, N. (2017). Hashimoto᾽s Thyroiditis. In: Feingold K. R., Anawalt B., Boyce A. et al. Eds. South Dartmouth (MA). Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK285557
Motohashi, N., Vadapalli, J., Vanam, A., & Gollapudi, R. (2018). The impact of nutrition on hashimoto᾽s thyroiditis patients: an overview. J. Clin. Nutr. Metab., 2 (2), 2-6. DOI: 10.4172/jcnm1000119
Klein, I., & Ojamaa, K. (2001). Thyroid hormone and cardiovascular system. N. Eng. J. Med., 344 (7), 501-509. DOI: 10.1056/NEJM200102153440707
Manolis, A.A., Manolis, T.A., Melita, H., & Manolis, A.S. (2020). Subclinical thyroid dysfunction and cardiovascular consequences: An alarming wake-up call? Trends Cardiovasc. Med., 30 (2), 57-69. DOI: 10.1016/j.tcm.2019.02.011
Langén, V.L., Niiranen, T.J., Puukka, P., Sundvall, J., & Jula, A.M. (2016). Association between thyroid-stimulating hormone and blood pressure in adults: an 11-year longitudinal study. Clin. Endocrinol. (Oxf), 84 (5), 741-747. DOI: 10.1111/cen.12876. Epub 2015 Sep 23.PMID: 26261034
Udovcic, M., Pena, R.H., Patham, B., Tabatabai, L., & Kansara, A. (2017). Hypothyroidism and the Heart. Methodist Debakey Cardiovasc J., 13 (2), 55-59. DOI: 10.14797/mdcj-13-2-55
Rugge, J.B., Bougatsos, C., & Chou, R. (2015). Creening and treatment of thyroid dysfunction: an evidence review for the U.S. Preventive Services Task Force. Ann Intern Med., 162 (1), 35-45. DOI: 10.7326/M14-1456
Biondi, B., & Klein, I. (2004). Hypothyroidism as a risk factor for cardiovascular disease. Endocrine, 24 (1), 1-13. DOI: 10.1385/ENDO:24:1:001
Dey, A., Kanneganti, V., Das, D. (2019). A study of the cardiac risk factors emerging out of subclinical hypothyroidism. J. Family Med. Prim. Care., 8 (7), 2439-2444. DOI: 10.4103/jfmpc.jfmpc_348_19
Monzani, F., Di Bello, V., Caraccio, N., Bertini, A., Giorgi, D., Giusti, C., & Ferrannini, E. (2001). Effect of levothyroxine on cardiac function and structure in subclinical hypothyroidism: A double-blind, placebo controlled study. J. Clin. Endocrinol. Metab., 86 (3), 1110-1115. DOI: 10.1210/jcem.86.3.7291
Zile, M.R., & Brutsaert, D.L. (2002). New concepts in diastolic dysfunction and diastolic cardiac failure. Part 2: Causal mechanism and treatment. Circulation, 105, 1503-1508. DOI: 10.1161/hc1202.105290
Inoue, K., Ritz, B., Brent, G.A., Ebrahimi, R., Rhee, C.M., & Leung, A.M. (2020). Association of subclinical hypothyroidism and cardiovascular disease with mortality. JAMA Netw. Open., 3 (2), e1920745. DOI: 10.1001/jamanetworkopen.2019.20745
Nair, S.N., Kumar, H., Raveendran, M., & Menon, V.U. (2018). Subclinical hypothyroidism and cardiac risk: lessons from a South Indian population study. Ind. J. Endocrinol. Metab., 22 (2), 217-222. DOI: 10.4103/ijem.IJEM_298_17
Fogoros, R.N., & Ali, Y.S. (2020). How does thyroid disease affect the heart? Retrieved from: https://www.verywellhealth.com/thyroid-disease-and-the-heart-1746112
Kim, E.J., Lyass, A., Wang, N., Massaro, J.M., Fox, C.S., Benjamin, E.J., & Magnani, J.W. (2014). Relation of hypothyroidism and incident atrial fibrillation (from the Framingham Heart Study). Am. Heart J., 167 (1), 123-126. DOI: 10.1016/j.ahj.2013.10.012
Zhou, Y., Chen, Y., Cao, X., Liu, C., & Xie, Y. (2014). Association between plasma homocysteine status and hypothyroidism: a meta-analysis. Int. J. Clin. Exp. Med., 7 (11), 4544-4553
Razvi, S., Jabbar, A., Pingitore, A., Danzi, S., Biondi, B., Klein, I., & Iervasi, G. (2018). Thyroid hormones and cardiovascular function and diseases. J. Am. Coll. Cardiol., 71 (16), 1781-1796. DOI: 10.1016/j.jacc.2018.02.045
Monzani, F., Caraccio, N., Kozàkowà, M., Dardano, A., Vittone, F., Virdis, A., & Ferrannini, E. (2004). Effect of levothyroxine replacement on lipid profile and intima-media thickness in subclinical hypothyroidism: a double-blind, placebo-controlled study. J. Clin. Endocrinol. Metab., 89 (5), 2099-2106. DOI: 10.1210/jc.2003-031669
Chahine, J., Ala, C.K., Gentry, J.L., Pantalone, K.M., & Klein, A.L. (2019). Pericardial diseases in patients with hypothyroidism. Heart, 105 (13), 1027-1033. DOI: 10.1136/heartjnl-2018-314528
Korzheletskyi, O.S., & Datsiuk, O.R. (2015). Ekhokardiohrafichna otsinka livoho shlunochka [chocardiographic assessment of the left ventricle]. Aktualni problemy klinichnoi ta profilaktychnoi medytsyny – Actual Problems of Clinical and Preventive Medicine, 3, 3-4, 40-52 [in Ukrainian].
Hadzović-Dzuvo, A., Kucukalić-Selimović, E., Nakas-Ićindić, E., Rasić, S., Begić, A., Al Tawil, D., & Lepara, O. (2010). Echocardiographic evaluation of cardiac function in female patients with thyroid disorders. Bosn. J. Basic Med. Sci., 10 (2), 112-5. DOI: 10.17305/bjbms.2010.2704
Zelinska, N.B. (2002). Arterialna hipertenziia pry hipotyreozi [Arterial hypertension in hypothyroidism]. Ukrainskyi medychnyi chasopys – Ukrainian Medical Journal, 6 (32), 47-52 [in Ukrainian].
Horodynska, O.Yu., Bobyrova, L.Ye., Vesnina, L.E., Izmailova, O.V., & Baranova, A.F. (2019). Osoblyvosti remodeliuvannia miokarda livoho shlunochka pry hipotyreozi i ishemichnii khvorobi sertsia na tli khronichnoho systemnoho zapalennia [Features of left ventricular remodeling in hypothyroidism and ischemic heart disease on the background of chronic systemic inflammation]. Mizhnarodnyi endokrynolohichnyi zhurnal – International Journal of Endocrinology (Ukraine), 15 (2), 128-132. DOI: 10.22141/2224-0721.15.2.2019.166104 [in Ukrainian].
Zelinska, N.B. (2008). Klinichni proiavy urazhennia sertsevo-sudynnoi systemy u khvorykh na hipotyreoz [Clinical manifestations of cardiovascular lesions in patients with hypothyroidism]. Klinichna endokrynolohiia ta endokrynna khirurhiia – Clinical Endocrinology and Endocrine Surgery, 1 (22), 18-27 [in Ukrainian].
Davis, J.D., & Kovar, A.J. (2020). The cardiovascular effects of subclinical thyroid dysfunction. J. Cardiothorac. Vasc. Anesth., 34 (1), 35-38. DOI: 10.1053/j.jvca.2019.08.020
Floriani, C., Gencer, B., Collet, T.H., & Rodondi, N. (2018). Subclinical thyroid dysfunction and cardiovascular diseases: 2016 update. Eur. Heart J., 39 (7), 503-507. DOI: 10.1093/eurheartj/ehx050
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