First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece.
Rev Endocr Metab Disord. 2022 Jun;23(3):621-630. doi: 10.1007/s11154-022-09713-0. Epub 2022 Feb 2.
Atrial fibrillation (AF) tends to occur frequently in patients with thyroid disease, primarily hyperthyroidism. In hyperthyroidism, increased levels of thyroid hormones, via intra- and extranuclear mechanisms, have profound effects on cardiac electrophysiology. Hypothyroidism carries a lower risk for AF and is mainly associated with the overtreatment of hypothyroid patients. New-onset AF is frequently the only manifestation of thyroid disease, which renders screening for thyroid dysfunction in that scenario clinically useful. Managing thyroid disease and comorbid AF is essential. This includes thyroid hormones control along with conventional AF therapy. However, there are several open issues with this comorbid duo. The optimal management of thyroid disease and its impact on AF burden remains obscure. There is scanty information on clear-cut benefits for therapy of subclinical thyroid disease and screening of asymptomatic patients. Furthermore, the immunogenetic overlap between the autoantibodies in Graves' disease and AF genesis may lead to novel therapeutic implications. The objective of this review is to summarize the up-to-date epidemiology, pathogenesis, pathophysiology and management of interacting thyroid disease and AF.
心房颤动（AF）在甲状腺疾病患者中较为常见，主要为甲状腺功能亢进症。在甲状腺功能亢进症中，甲状腺激素水平的升高通过核内和核外机制对心脏电生理学产生深远影响。甲状腺功能减退症发生 AF 的风险较低，主要与甲状腺功能减退症患者的过度治疗有关。新发 AF 常是甲状腺疾病的唯一表现，因此在这种情况下筛查甲状腺功能障碍具有临床意义。管理甲状腺疾病和合并的 AF 至关重要。这包括控制甲状腺激素以及常规的 AF 治疗。然而，对于这种合并症有几个尚未解决的问题。甲状腺疾病的最佳管理及其对 AF 负担的影响仍不清楚。对于亚临床甲状腺疾病的治疗和无症状患者的筛查，尚缺乏明确获益的信息。此外，格雷夫斯病中的自身抗体与 AF 发病机制之间的免疫遗传重叠可能导致新的治疗意义。本综述的目的是总结甲状腺疾病和 AF 相互作用的最新流行病学、发病机制、病理生理学和管理。
