BACKGROUND: Triiodothyronine (T3) has many effects on the heart, and marked changes in cardiac function and structure occur in patients with (subclinical) thyroid disease. We investigated whether between-subject variation in thyroid hormone levels within the euthyroid range is also associated with heart rate and echocardiographic heart function and structure. METHODS: Subjects were selected from the Asklepios study (n=2524), a population-representative random sample of patients aged between 35 and 55 years, free from overt cardiovascular disease at baseline. Analyses were restricted to 2078 subjects (1013 women and 1065 men), not using antihypertensive or thyroid medication nor having antithyroperoxidase antibody levels above clinical cut-off or thyrotropin (TSH) levels outside the reference range. All subjects were phenotyped in-depth and underwent comprehensive echocardiography, including diastolic evaluation. Thyroid function parameters were determined by automated electrochemiluminescence. RESULTS: Heart rate was robustly positively associated with (quartiles of) free T3 (FT3) and T3, both in subjects with TSH levels within reference (0.27-4.2 μU/L) and in narrow TSH range (0.5-2.5 μU/L; p<0.0001). FT3 and T3 were negatively associated with left ventricular (LV) end-diastolic volume but positively associated with relative wall thickness. Total T3 (TT3) was associated with enhanced ventricular contraction (as assessed by tissue Doppler imaging). Free thyroxine, FT3, and TT3 were positively associated with late ventricular filling, and TT3 was associated with early ventricular filling. CONCLUSION: We have demonstrated a strong positive association between thyroid hormone levels within the euthyroid range and heart rate, and more subtle effects on cardiac function and structure. More specifically, we suggest a smaller LV cavity size (with increased relative wall thickness), an enhanced atrial and ventricular contraction, and LV relaxation with higher circulating thyroid hormones. These results illustrate that variation in thyroid hormone levels, even within the reference range, exerts effects on the heart.
BACKGROUND:Triiodothyronine (T3) has many effects on the heart, and marked changes in cardiac function and structure occur in patients with (subclinical) thyroid disease. We investigated whether between-subject variation in thyroid hormone levels within the euthyroid range is also associated with heart rate and echocardiographic heart function and structure. METHODS: Subjects were selected from the Asklepios study (n=2524), a population-representative random sample of patients aged between 35 and 55 years, free from overt cardiovascular disease at baseline. Analyses were restricted to 2078 subjects (1013 women and 1065 men), not using antihypertensive or thyroid medication nor having antithyroperoxidase antibody levels above clinical cut-off or thyrotropin (TSH) levels outside the reference range. All subjects were phenotyped in-depth and underwent comprehensive echocardiography, including diastolic evaluation. Thyroid function parameters were determined by automated electrochemiluminescence. RESULTS: Heart rate was robustly positively associated with (quartiles of) free T3 (FT3) and T3, both in subjects with TSH levels within reference (0.27-4.2 μU/L) and in narrow TSH range (0.5-2.5 μU/L; p<0.0001). FT3 and T3 were negatively associated with left ventricular (LV) end-diastolic volume but positively associated with relative wall thickness. Total T3 (TT3) was associated with enhanced ventricular contraction (as assessed by tissue Doppler imaging). Free thyroxine, FT3, and TT3 were positively associated with late ventricular filling, and TT3 was associated with early ventricular filling. CONCLUSION: We have demonstrated a strong positive association between thyroid hormone levels within the euthyroid range and heart rate, and more subtle effects on cardiac function and structure. More specifically, we suggest a smaller LV cavity size (with increased relative wall thickness), an enhanced atrial and ventricular contraction, and LV relaxation with higher circulating thyroid hormones. These results illustrate that variation in thyroid hormone levels, even within the reference range, exerts effects on the heart.
Authors: N B Schiller; P M Shah; M Crawford; A DeMaria; R Devereux; H Feigenbaum; H Gutgesell; N Reichek; D Sahn; I Schnittger Journal: J Am Soc Echocardiogr Date: 1989 Sep-Oct Impact factor: 5.251
Authors: J W A Smit; C F A Eustatia-Rutten; E P M Corssmit; A M Pereira; M Frölich; G B Bleeker; E R Holman; E E van der Wall; J A Romijn; J J Bax Journal: J Clin Endocrinol Metab Date: 2005-08-30 Impact factor: 5.958
Authors: Rogério Silva de Paula; Ivana Antelmi; Marcos Antonio Vincenzi; Carmen D S André; Rinaldo Artes; Cesar José Grupi; Alfredo José Mansur Journal: Int J Cardiol Date: 2005-11-02 Impact factor: 4.164
Authors: Marcus Dörr; Birger Wolff; Daniel M Robinson; Ulrich John; Jan Lüdemann; Wieland Meng; Stephan B Felix; Henry Völzke Journal: J Clin Endocrinol Metab Date: 2004-11-02 Impact factor: 5.958
Authors: Greet L Roef; Ernst R Rietzschel; Caroline M Van Daele; Youri E Taes; Marc L De Buyzere; Thierry C Gillebert; Jean-Marc Kaufman Journal: Thyroid Date: 2013-11-14 Impact factor: 6.568
Authors: João Sérgio Neves; Ricardo Fontes-Carvalho; Marta Borges-Canha; Ana Rita Leite; Sandra Martins; Ana Oliveira; João Tiago Guimarães; Davide Carvalho; Adelino Leite-Moreira; Ana Azevedo Journal: Eur Thyroid J Date: 2020-07-08
Authors: Anh N Do; Wei Zhao; Abigail S Baldridge; Laura M Raffield; Kerri L Wiggins; Sanjiv J Shah; Stella Aslibekyan; Hemant K Tiwari; Nita Limdi; Degui Zhi; Colleen M Sitlani; Kent D Taylor; Bruce M Psaty; Nona Sotoodehnia; Jennifer A Brody; Laura J Rasmussen-Torvik; Donald Lloyd-Jones; Leslie A Lange; James G Wilson; Jennifer A Smith; Sharon L R Kardia; Thomas H Mosley; Ramachandran S Vasan; Donna K Arnett; Marguerite R Irvin Journal: Mol Genet Genomic Med Date: 2019-08-13 Impact factor: 2.473
Authors: Venkatesh L Murthy; Ravi V Shah; Jared P Reis; Alexander R Pico; Robert Kitchen; Joao A C Lima; Donald Lloyd-Jones; Norrina B Allen; Mercedes Carnethon; Gregory D Lewis; Matthew Nayor; Ramachandran S Vasan; Jane E Freedman; Clary B Clish Journal: Circulation Date: 2020-10-19 Impact factor: 29.690
Authors: Alexander Teumer; Layal Chaker; Stefan Groeneweg; Yong Li; Celia Di Munno; Caterina Barbieri; Ulla T Schultheiss; Michela Traglia; Tarunveer S Ahluwalia; Masato Akiyama; Emil Vincent R Appel; Dan E Arking; Alice Arnold; Arne Astrup; Marian Beekman; John P Beilby; Sofie Bekaert; Eric Boerwinkle; Suzanne J Brown; Marc De Buyzere; Purdey J Campbell; Graziano Ceresini; Charlotte Cerqueira; Francesco Cucca; Ian J Deary; Joris Deelen; Kai-Uwe Eckardt; Arif B Ekici; Johan G Eriksson; Luigi Ferrrucci; Tom Fiers; Edoardo Fiorillo; Ian Ford; Caroline S Fox; Christian Fuchsberger; Tessel E Galesloot; Christian Gieger; Martin Gögele; Alessandro De Grandi; Niels Grarup; Karin Halina Greiser; Kadri Haljas; Torben Hansen; Sarah E Harris; Diana van Heemst; Martin den Heijer; Andrew A Hicks; Wouter den Hollander; Georg Homuth; Jennie Hui; M Arfan Ikram; Till Ittermann; Richard A Jensen; Jiaojiao Jing; J Wouter Jukema; Eero Kajantie; Yoichiro Kamatani; Elisa Kasbohm; Jean-Marc Kaufman; Lambertus A Kiemeney; Margreet Kloppenburg; Florian Kronenberg; Michiaki Kubo; Jari Lahti; Bruno Lapauw; Shuo Li; David C M Liewald; Ee Mun Lim; Allan Linneberg; Michela Marina; Deborah Mascalzoni; Koichi Matsuda; Daniel Medenwald; Christa Meisinger; Ingrid Meulenbelt; Tim De Meyer; Henriette E Meyer Zu Schwabedissen; Rafael Mikolajczyk; Matthijs Moed; Romana T Netea-Maier; Ilja M Nolte; Yukinori Okada; Mauro Pala; Cristian Pattaro; Oluf Pedersen; Astrid Petersmann; Eleonora Porcu; Iris Postmus; Peter P Pramstaller; Bruce M Psaty; Yolande F M Ramos; Rajesh Rawal; Paul Redmond; J Brent Richards; Ernst R Rietzschel; Fernando Rivadeneira; Greet Roef; Jerome I Rotter; Cinzia F Sala; David Schlessinger; Elizabeth Selvin; P Eline Slagboom; Nicole Soranzo; Thorkild I A Sørensen; Timothy D Spector; John M Starr; David J Stott; Youri Taes; Daniel Taliun; Toshiko Tanaka; Betina Thuesen; Daniel Tiller; Daniela Toniolo; Andre G Uitterlinden; W Edward Visser; John P Walsh; Scott G Wilson; Bruce H R Wolffenbuttel; Qiong Yang; Hou-Feng Zheng; Anne Cappola; Robin P Peeters; Silvia Naitza; Henry Völzke; Serena Sanna; Anna Köttgen; Theo J Visser; Marco Medici Journal: Nat Commun Date: 2018-10-26 Impact factor: 14.919