Mastorci Francesca, Sabatino Laura, Vassalle Cristina, Pingitore Alessandro
Clinical Physiology Institute, CNR, Pisa, Italy.
Fondazione G. Monasterio, CNR-Regione Toscana, Pisa, Italy.
Front Endocrinol (Lausanne). 2020 Jan 28;10:927. doi: 10.3389/fendo.2019.00927. eCollection 2019.
Ischemic heart disease is the main cause of morbidity and mortality worldwide and is becoming more widespread with population aging. Cardioprotection is a dynamic process characterized by mechanisms related to myocardial damage and activation of protective factors. Targeting these processes could be attractive as a new therapeutic strategy in the evolution of post-ischemic heart failure (HF). In this context, the role of thyroid hormone (TH)-mediated cardioprotection is supported by a number of findings regarding the modulation of neuroendocrine systems, inflammatory and oxidative stress status, pro-survival intracellular pathways, and epigenetic factors, its effects on cardiac angiogenesis, structure, and function and on the preservation of mitochondrial function and morphology, and its beneficial effects on cell growth and redifferentiation. Moreover, the numerous effects of TH on the heart involve genomic mechanisms, which include cardiac differentiation during the perinatal period and non-genomic action, directed toward the maintenance of cardiovascular homeostasis. This evidence suggests that there is an opportunity to treat HF patients with TH. This review is mainly focused on the clinical evidence of the role of the thyroid system in the complex setting of HF.
缺血性心脏病是全球发病和死亡的主要原因，并且随着人口老龄化正变得越来越普遍。心脏保护是一个动态过程，其特征在于与心肌损伤和保护因子激活相关的机制。在缺血性心力衰竭（HF）的发展过程中，针对这些过程作为一种新的治疗策略可能具有吸引力。在这种背景下，甲状腺激素（TH）介导的心脏保护作用得到了一些研究结果的支持，这些结果涉及神经内分泌系统的调节、炎症和氧化应激状态、促生存细胞内途径以及表观遗传因素，其对心脏血管生成、结构和功能以及线粒体功能和形态的保存的影响，以及其对细胞生长和再分化的有益作用。此外，TH对心脏的众多影响涉及基因组机制，包括围产期心脏分化和非基因组作用，旨在维持心血管稳态。这一证据表明有机会用TH治疗HF患者。本综述主要关注甲状腺系统在HF复杂背景下作用的临床证据。
