Cardiothoracic Department, University of Pisa, Pisa, Italy.
Heart Fail Rev. 2010 Mar;15(2):155-69. doi: 10.1007/s10741-008-9126-6. Epub 2008 Dec 27.
Thyroid hormone (TH) has a fundamental role in cardiovascular homeostasis in both physiological and pathological conditions, influencing cardiac contractility, heart rate (HR), diastolic function and systemic vascular resistance (SVR) through genomic and non-genomic mediated effects. In heart failure (HF) the main alteration of thyroid function is referred to as "low-triiodothyronine (T3) syndrome" (LT3S) characterized by decreased total serum T3 and free T3 (fT3) with normal levels of thyroxine (T4) and thyrotropin (TSH). Even if commonly interpreted as an adaptive factor, LT3S may have potential negative effects, contributing to the progressive deterioration of cardiac function and myocardial remodeling in HF and representing a powerful predictor of mortality in HF patients. All these observations, together with the early evidence of the benefits of T3 administration in HF patients indicate that placebo-controlled prospective studies are now needed to better define the safety and prognostic effects of chronic treatment with synthetic TH in HF.
甲状腺激素（TH）在生理和病理条件下对心血管稳态具有重要作用，通过基因组和非基因组介导的作用影响心肌收缩力、心率（HR）、舒张功能和全身血管阻力（SVR）。在心力衰竭（HF）中，甲状腺功能的主要改变被称为“低三碘甲状腺原氨酸（T3）综合征”（LT3S），其特征是总血清 T3 和游离 T3（fT3）降低，而甲状腺素（T4）和促甲状腺激素（TSH）水平正常。尽管通常被解释为一种适应性因素，但 LT3S 可能具有潜在的负面影响，导致 HF 中心脏功能和心肌重构的进行性恶化，并代表 HF 患者死亡率的有力预测因素。所有这些观察结果，再加上 T3 给药在 HF 患者中早期获益的证据表明，现在需要进行安慰剂对照的前瞻性研究，以更好地确定 HF 患者中慢性合成 TH 治疗的安全性和预后效果。
