Roslyn, NY — What is the relationship between thyroid dysfunction and measures of myocardial disease in older patients?
That was the question asked in a study led by researchers from The Heart Center/SUNY at Stony Brook, the San Francisco VA HealthCare System and the University of California, San Francisco.
The goal was to evaluate the effect of thyroid dysfunction on structure and function of the left-heart chambers and blood markers of cardiac disease. Results of the cross-sectional analysis were published in the Journal of Clinical Endocrinology & Metabolism.1
Participants came from the Cardiovascular Health Study, a community-based cohort of older individuals recruited from four urban areas in the United States. Of 3,163 participants studied, 2,477 were euthyroid, 465 had subclinical hypothyroidism (SCH), 47 overt hypothyroidism (OH), 45 endogenous (endo) subclinical hyperthyroidism (endo-SCT), and 129 had exogenous (exo) SCT due to thyroid hormone supplementation, based on clinical evaluation, blood sampling and biomarker measurement, as well as two-dimensional and speckle-tracking echocardiography.
Defined as the main outcome measure were left heart myocardial deformation, circulating biomarkers of diastolic overload (NT-proBNP), fibrosis (sST2, gal-3) and cardiomyocyte injury (hs-cTnT).
Results indicated that SCH was associated with higher NT-proBNP (beta = 0.17, p = 0.004), while OH was associated with higher hs-cTnT (beta = 0.29, p = 0.005). “There were also suggestive associations of SCH with higher sST2, as well as endo-SCT with higher gal-3 and lower (worse) left atrial reservoir strain,” the authors advised. “Left ventricular longitudinal strain and end-diastolic strain rate did not differ significantly from euthyroid participants in SCH, OH, or exo-SCT.”
The study authors concluded, “In this free-living elderly cohort, subclinical and overt hypothyroidism were associated with abnormalities of blood biomarkers consistent with diastolic overload and myocardial necrosis respectively, whereas subclinical hyperthyroidism tended to be associated with myocardial fibrosis and decreased left atrial strain. Our findings could represent stage B heart failure and illuminate distinct aspects of the pathobiology of heart disease related to thyroid gland dysfunction with potential clinical implications.”
- Barasch E, Gottdiener J, Buzkova P, Cappola A, Shah S, DeFilippi C, Gardin J, Kizer JR. Association of thyroid dysfunction in individuals ≥ 65 years of age with subclinical cardiac abnormalities. J Clin Endocrinol Metab. 2024 Jan 6:dgae001. doi: 10.1210/clinem/dgae001. Epub ahead of print. PMID: 38183678.
