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甲状腺激素在心脏功能中发挥重要作用:从实验台到病床边

Thyroid Hormone Plays an Important Role in Cardiac Function: From Bench to Bedside.

作者信息

Yamakawa Hiroyuki, Kato Tomoko S, Noh Jaeduk Yoshimura, Yuasa Shinsuke, Kawamura Akio, Fukuda Keiichi, Aizawa Yoshiyasu

机构信息

Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.

Center for Preventive Medicine, Keio University School of Medicine, Tokyo, Japan.

出版信息

Front Physiol. 2021 Oct 18;12:606931. doi: 10.3389/fphys.2021.606931. eCollection 2021.

Abstract

Thyroid hormones (THs) are synthesized in the thyroid gland, and they circulate in the blood to regulate cells, tissues, and organs in the body. In particular, they exert several effects on the cardiovascular system. It is well known that THs raise the heart rate and cardiac contractility, improve the systolic and diastolic function of the heart, and decrease systemic vascular resistance. In the past 30 years, some researchers have studied the molecular pathways that mediate the role of TH in the cardiovascular system, to better understand its mechanisms of action. Two types of mechanisms, which are genomic and non-genomic pathways, underlie the effects of THs on cardiomyocytes. In this review, we summarize the current knowledge of the action of THs in the cardiac function, the clinical manifestation and parameters of their hemodynamics, and treatment principles for patients with hyperthyroid- or hypothyroid-associated heart disease. We also describe the cardiovascular drugs that induce thyroid dysfunction and explain the mechanism underlying the thyroid toxicity of amiodarone, which is considered the most effective antiarrhythmic agent. Finally, we discuss the recent reports on the involvement of thyroid hormones in the regulation of myocardial regeneration and metabolism in the adult heart.

摘要

甲状腺激素(THs)在甲状腺中合成,它们在血液中循环以调节身体中的细胞、组织和器官。特别是,它们对心血管系统有多种作用。众所周知,THs可提高心率和心脏收缩力,改善心脏的收缩和舒张功能,并降低全身血管阻力。在过去30年中,一些研究人员研究了介导TH在心血管系统中作用的分子途径,以更好地理解其作用机制。THs对心肌细胞的作用有两种机制,即基因组途径和非基因组途径。在这篇综述中,我们总结了目前关于THs在心脏功能中的作用、其血流动力学的临床表现和参数,以及甲状腺功能亢进或减退相关心脏病患者的治疗原则的知识。我们还描述了导致甲状腺功能障碍的心血管药物,并解释了被认为是最有效的抗心律失常药物胺碘酮的甲状腺毒性的潜在机制。最后,我们讨论了关于甲状腺激素参与成年心脏心肌再生和代谢调节的最新报道。

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