Chair and Department of Cardiology-Intensive Therapy and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland.
Chair and Department of Endocrinology, Metabolism, and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland.
Endokrynol Pol. 2020;71(5):466-478. doi: 10.5603/EP.a2020.0052.
There is an intimate and functional relationship between the cardiovascular system and the thyroid gland; from sharing the same embryologic origin to modulating each of the components of the heart for a normal function. Due to this relationship, patients suffering from cardiovascular diseases often undergo a thyroid function test to rule out hypo- or hyperthyroidism. The signs and symptoms of hyper- and hypothyroidism are clinically relevant and profound. The cardiac function changes can be explained through the cellular mechanism of the thyroid hormone action on the heart. Minor alteration of thyroid hormone can change vascular resistance, cardiac contractility, blood pressure, and heart rhythm, because of the presence of the thyroid hormone receptors on these tissues. A better understanding of the impact of thyroid hormones on the cardiovascular system is paramount for physicians to make a quick decision and initiate a treatment plan because it has been shown to reverse some of the cardiac changes such as systolic and diastolic dysfunction. With this literature review, we aim to describe the holistic effect of thyroid hormones on the cardiovascular system, from its effect on a cellular level to changes in cardiac functions in subclinical and overt hypo/hyperthyroidism. Additionally, we will describe the effects of the drug treatment regimen of thyroid on the cardiac function.
心血管系统和甲状腺之间存在着密切的功能关系；从共享相同的胚胎起源到调节心脏的各个组成部分以实现正常功能。由于这种关系，患有心血管疾病的患者通常会进行甲状腺功能检查，以排除甲状腺功能减退或甲状腺功能亢进。甲状腺功能亢进和减退的症状和体征在临床上是相关的且深刻的。心脏功能的变化可以通过甲状腺激素对心脏的细胞作用机制来解释。由于这些组织存在甲状腺激素受体，甲状腺激素的微小改变可以改变血管阻力、心肌收缩力、血压和心率。更好地了解甲状腺激素对心血管系统的影响对于医生做出快速决策和启动治疗计划至关重要，因为它已被证明可以逆转一些心脏变化，如收缩和舒张功能障碍。通过这篇文献综述，我们旨在描述甲状腺激素对心血管系统的整体影响，从其对细胞水平的影响到亚临床和显性甲状腺功能减退/亢进时心脏功能的变化。此外，我们将描述甲状腺药物治疗方案对心脏功能的影响。
