Hypothyroidism in Association with Heart Diseases Among Patients Admitted to Cardiac Care Unit
Abstract
Background: Heart disease is the prominent reason of death globally. Especially associated with modern risk factors such as diabetes, dyslipidemia and hypertension, which are grossly share to development of heart diseases. Thorough management of these risk factors is related with significant lowering of hazard of cardiovascular disease in general
Aim of study to assess the relationship between hypothyroidism and heart diseases and which types of heart disease more associated with hypothyroism.
Patients and methods: A cross sectional study was conducted at Diwanhyia teaching hospital in Al-Diwanhyia governorate, Iraq. The study was achieved through period from 1st of June 2022 to 1st February 2023. A sample of 80 patients with heart diseases were admitted to cardiac unite in hospital from both sex, above 18 years were included in the study.
Result : Eighty patients with mean age 57 years divided in 3 groups according to age. In our sample the heart failure patients were 42.5%, unstable angina were 26.3% and myocardial infarction were 31.2%. Prevalence of hypothyroidism among sample of patients with cardiac problems was 20% and 80% of patients have no such condition, as table 4. Moreover, hypothyroidism presented in patients with heart failure, angina and myocardial infarction was 32.3%, 9.5% and 12% respectively.
Conclusion: Hypothyroidism is associated with increased risk of cardiac disease, hypothyroidism are more common in heart failure. Hypothyroidism has a wide spectrum of clinical exhibitions. Not only major variations, but also indirect changes in the circulating pool of thyroid hormone may cause or share to cardiovascular disorder risk.
References
2. Jabbar A, Pingitore A, Pearce SH, Zaman A, Iervasi G, Razvi S. Thyroid hormones and cardiovascular disease. Nat Rev Cardiol 2017;14:39–55.
3. Pingitore A, Nicolini G, Kusmic C, Iervasi G,Grigolini P, Forini F. Cardioprotection and thyroid hormones. Heart Fail Rev 2016;21:391–9.
4. Ozen K, Süleyman A, Polat C, Ede H, Ozturk O. Relation between Thyroid Stimulating Hormone and Left Ventricular Strain Parameters in Patients with Subclinical Hypothyroidism. American Journal of Cardiology.2018;121(8):e5–6.
5. Lee Y, Lim YH, Shin JH, Park J, Shin J. Impact of subclinical hypothyroidism on clinical outcomes following percutaneous coronary intervention. Int J Cardiol. 2018;253:155-160.
6. Langen VL, Niiranen TJ, Puukka P, Lehtonen AO, Hernesniemi JA, Sundvall J, et al. Thyroid-stimulating hormone and risk of sudden cardiac death, total mortality and cardiovascular morbidity. Clin Endocrinol (Oxf). 2018;88(1):105–13.
7. Yamakawa H, Kato TS, Noh JY, Yuasa S, Kawamura A, Fukuda K, et al. Thyroid Hormone Plays an Important Role inCardiac Function: From Bench to Bedside. Front Physiol. 2021;12:606931.
8. Favuzzi AMR, Venuti A, Bruno C, Nicolazzi MA, Fuorlo M, Dajko M, et al. Hormonal deficiencies in heart failure with preserved ejection fraction: prevalence and impact on diastolic dysfunction: a pilot study.
Eur Rev Med Pharmacol Sci. 2020;24(1):352–61.
9. Cappola AR, Desai AS, Medici M, Cooper LS, Egan D, Sopko G, et al. Thyroid and Cardiovascular Disease: Research Agenda for Enhancing Knowledge, Prevention, and Treatment. Thyroid. 2019;29(6):760–77.
10. Neves JS, Vale C, von Hafe M, Borges-Canha M, Leite AR, Almeida-Coelho J, et al. Thyroid hormones and modulation of diastolic function: a promising target for heart failure with preserved ejection fraction. Ther Adv Endocrinol Metab. 2020;11:2042018820958330.
11. Yemele Honoré K, Ama Moor VJ, Mfeukeu Kuate L, Martine E. Frequency and Relevance of Thyroid Dysfunction in Patients with Chronic Heart Failure: a Cross Sectional Study at Yaoundé Central Hospital, Cameroon. Arch Clin Biomed Res. 2021;5(1):129.
12. Bekkering GE, Agoritsas T, Lytvyn L, et al. Thyroid hormones treatment for subclinical hypothyroidism: a clinical practice guideline. BMJ.2019;365:l2006. doi:10.1136/bmj.l2006
13. Aljabri KS, Alnasser IM, Facharatz BS, Bokhari SA, Alshareef MA, Khan PM, et al. The frequency of hypothyroidism in Saudi community based hospital: A retrospective single centre study. Trends Diabetes Metab 2019;2:1 2.
14. Mfeukeu-Kuate L, Yemele HK, Jingi AM, et al. Burden, Type, and Associated Factors of Thyroid Dysfunction in Patients with Heart Failure in Sub-Saharan Africa: a Cross-Sectional Study. World J Cardiovasc Dis. 2021;11(11):485–497
15. Triggiani V, Iacoviello M, Monzani F, Puzzovivo A, Guida P, Forleo C, Ciccone MM, Catanzaro R, Tafaro E, Licchelli B, Giagulli VA, Guastamacchia E, Favale S. Incidence and prevalence of hypothyroidism in patients affected by chronic heart failure: role of amiodarone. Endocr Metab Immune Disord Drug Targets. 2012 Mar;12(1):86-94.
16. Yu Sato, Akiomi Yoshihisa, Yusuke Kimishima, Takatoyo Kiko. Subclinical Hypothyroidism Is Associated With Adverse Prognosis in Heart Failure Patients. Canadian Journal of Cardiology:2018:Volume 34, Issue 1:Pages 80-87.
17. Hayashi T, Hasegawa T, Kanzaki H. Subclinical hypothyroidism isan independent predictor of adverse cardiovascular outcomes in patients with acute decompensated heart failure. ESC Heart Fail 2016;3:168-76.
18. Gencer B, Collet TH, Virgini V. Subclinical thyroid dysfunction and the risk of heart failure events: an individual participant data analysis from 6 prospective cohorts. Circulation 2012;126:1040-9.
19. Biondi B, Kahaly GJ. Cardiovascular involvement in patients with different causes of hyperthyroidism. Nat Rev Endocrinol. 2010;6(8):431–443. doi:10.1038/nrendo.2010.105
20. Brenta, G., Vaisman, M., Sgarbi, J. A., Bergoglio, L. M., Andrada, N. C. de ., Bravo, P. P., Orlandi, A. M., & Graf, H.. (2013). Clinical practice guidelines for the management of hypothyroidism. Arquivos Brasileiros De Endocrinologia & Metabologia, 57(4), 265–291
21. Erkan G, Erkan AF, Cemri M, Karaahmetoglu S, Cesur M, Cengel A. The evaluation of diastolic dysfunction with tissue Doppler echocardiographyin women with subclinical hypothyroidism and the effect of L-thyroxine treatment on diastolic dysfunction: a pilot study.
J Thyroid Res. 2011;2011:654304.
22. Kannan L, Shaw PA, Morley MP, Brandimarto J, Fang JC, Sweitzer NK. Thyroid Dysfunction in Heart Failure and Cardiovascular Outcomes. Circ Heart Fail. 2018;11(12):e005266. DOI: 10.1161/CIRCHEARTFAILURE.118.005266
23. Lee Y, Lim YH, Shin JH, Park J, Shin J. Impact of subclinical hypothyroidism on clinical outcomes following percutaneous coronary intervention. Int J Cardiol. 2018;253:155-160.
24. Jabbar A, Ingoe L, Junejo S, Carey P, Addison C, Thomas H. Effect of Levothyroxine on Left Ventricular Ejection Fraction in Patients With Subclinical Hypothyroidism and Acute Myocardial Infarction: A Randomized Clinical Trial. JAMA. 2020;324(3):249–258. doi:10.1001/jama.2020.9389
25. Mahzari MM, Alserehi AH, Almutairi SA, Alanazi KH, Alharbi MA, Mohamud M.Hypothyroidism and the risk of coronary artery disease in Saudi patients. J Fam Community Med2022;29:34-40.
26. Razvi S, Leng O, Jabbar A, et al. Sample timing,,diagnosis of subclinical thyroid dysfunction and mortality in acutemyocardial infarction: ThyrAMI1 study. J Clin Endocrinol Metab. 2020;105(4):dgz143.
27. Arena R, Myers J, Guazzi M. Cardiopulmonary exercise testing is a core assessment for patients with heart failure. Congest Heart Fail 2011;17:115-9.
28. Fabregat-Andres O, Estornell-Erill J, Ridocci-Soriano F. Prognosticvalue of pulmonary vascular resistance estimated by cardiac magneticresonance in patients with chronic heart failure. Eur Heart J CardiovascImaging 2014;15:1391-9.
