Triggiani Vincenzo, Angelo Giagulli Vito, De Pergola Giovanni, Licchelli Brunella, Guastamacchia Edoardo, Iacoviello Massimo
1Endocrinology and Metabolic Diseases, Interdisciplinary Department of Medicine, University of Bari, Italy.
Endocr Metab Immune Disord Drug Targets. 2016;16(1):2-7. doi: 10.2174/1871530316666151218151319.
Subclinical hypothyroidism can be associated with the onset and progression of chronic heart failure.
We undertook a careful search of the literature aiming to review the possible pathogenetic mechanisms explaining the influence of subclinical hypothyroidism on the onset and progression of chronic heart failure.
Thyroid hormones can influence the expression of genes involved in calcium handling and contractile properties of myocardiocytes. Subclinical hypothyroidism, therefore, can alter both cardiovascular morphology and function leading to changes in myocardiocytes shape and structure, and to alterations of both contractile and relaxing properties, impairing systolic as well as diastolic functions. Furthermore, it can favour dyslipidemia, endothelial dysfunction and diastolic hypertension, favouring atherogenesis and coronary heart disease, possibly evolving into chronic heart failure. Beside an influence on the onset of chronic heart failure, subclinical hypothyroidism can represent a risk factor for its progression, in particular hospitalization and mortality but the mechanisms involved need to be fully elucidated.
Subclinical hypothyroidism can be associated with the onset of chronic heart failure, because it can favour two frequent conditions that can evolve in heart failure: coronary heart disease and hypertension; it can also alter both cardiovascular morphology and function leading to heart failure progression in patients already affected through mechanisms still not completely understood.
亚临床甲状腺功能减退可能与慢性心力衰竭的发生和进展相关。
我们对文献进行了仔细检索，旨在综述解释亚临床甲状腺功能减退对慢性心力衰竭发生和进展影响的可能发病机制。
甲状腺激素可影响参与心肌细胞钙处理和收缩特性的基因表达。因此，亚临床甲状腺功能减退可改变心血管形态和功能，导致心肌细胞形状和结构改变，以及收缩和舒张特性改变，损害收缩和舒张功能。此外，它可促进血脂异常、内皮功能障碍和舒张期高血压，促进动脉粥样硬化和冠心病的发生，可能发展为慢性心力衰竭。除了对慢性心力衰竭的发生有影响外，亚临床甲状腺功能减退还可能是其进展的危险因素，特别是住院率和死亡率，但其中涉及的机制仍需充分阐明。
亚临床甲状腺功能减退可能与慢性心力衰竭的发生相关，因为它可促进两种可发展为心力衰竭的常见情况：冠心病和高血压；它还可改变心血管形态和功能，导致已受影响患者的心力衰竭进展，其机制仍未完全明确。
