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Heart in Hypothyroidism

  • Bernadette BiondiEmail author
  • George J. Kahaly
Chapter

Abstract

The transition from the fetal to the adult phenotype heart depends on the increase in thyroid hormone (TH) in perinatal period (Liu and Gerdes, J Mol Cell Cardiol 22:1339–1348, 1990; Gerdes and Iervasi, Circulation 122:385–393, 2010). Moreover, T3 action is essential for preserving both cardiac morphology and performance in adult life because thyroid hormone controls the inotropic and lusitropic properties of the myocardium, cardiac growth, myocardial contractility, and vascular function (Liu and Gerdes, J Mol Cell Cardiol 22:1339–1348, 1990; Gerdes and Iervasi, Circulation 122:385–393, 2010; Fazio et al., Recent Prog Horm Res 59:31–50, 2002; Kahaly and Dillmann, Endocr Rev 26:704–728, 2005; Klein and Ojamaa, N Engl J Med 344:501–509, 2001; Biondi and Klein, Endocrine 24:1–13, 2004). Most patients with thyroid dysfunction experience cardiovascular (CV) manifestations, and the most serious complications of thyroid disease occur as a result of cardiac involvement (Fazio et al., Recent Prog Horm Res 59:31–50, 2002; Kahaly and Dillmann, Endocr Rev 26:704–728, 2005; Klein and Ojamaa, N Engl J Med 344:501–509, 2001; Biondi and Klein, Endocrine 24:1–13, 2004). Severe hypothyroidism or myxedema has a clinically relevant impact on the heart and on the cardiovascular system, and measurable changes in cardiovascular performance are detected even with small variations in thyroid hormone concentrations (Liu and Gerdes, J Mol Cell Cardiol 22:1339–1348, 1990; Gerdes and Iervasi, Circulation 122:385–393, 2010; Fazio et al., Recent Prog Horm Res 59:31–50, 2002; Kahaly and Dillmann, Endocr Rev 26:704–728, 2005; Klein and Ojamaa, N Engl J Med 344:501–509, 2001; Biondi and Klein, Endocrine 24:1–13, 2004).

Here we explore the hemodynamic alterations in overt and subclinical hypothyroidism (SHypo), their cardiovascular risks, the prevention and treatment of these disorders, and their cardiovascular complications.

Keywords

Subclinical hypothyroidism Overt hypothyroidism Cardiovascular risk Management l-thyroxine 

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Authors and Affiliations

  1. 1.Department of Clinical Medicine and SurgeryUniversity of Naples Federico IINaplesItaly
  2. 2.Department of Medicine IJohannes Gutenberg University Medical CenterMainzGermany

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