Setting the Stage: The Thyroid-Heart Connection
Thyroid hormones have long been a subject of study in the medical community, especially in relation to heart health. But how much do we really know? This recent meta-analysis dives deep into this intricate relationship.
Subclinical hypothyroidism (SCH) is known to affect cardiac diastolic function. The big question has always been: Can thyroid hormone replacement therapy turn the tables?
The Source Article Details
Effect of thyroid hormone replacement treatment on cardiac diastolic function in adult patients with subclinical hypothyroidism: a meta-analysis by Gejing Liu et al. in 2023.
The Source Article's Abstract
Although subclinical hypothyroidism (SCH) is related to abnormalities in left ventricular diastolic function, the use of levothyroxine as a regular treatment remains debatable. This meta-analysis aimed to determine whether thyroid hormone replacement therapy affects cardiac diastolic function in patients with SCH as measured by echocardiography.
This meta-analysis included a search of the EMBASE, PubMed, Web of Science, and Cochrane Library databases from their inception to May 18, 2023, for studies analyzing cardiac morphology and functional changes in patients with SCH before and after thyroid hormone replacement.
Seventeen studies met the inclusion criteria. A total of 568 patients participated and completed the follow-up. In terms of diastolic function, the ratios of E-velocity to A-velocity (E/A) had greatly improved after thyroid hormone replacement therapy.
In adult patients with SCH, thyroid hormone supplementation can partially but not completely improve parameters of diastolic function during the observation period.
The Source Article References
- Subclinical hypothyroidism: A review by Biondi, 2019 in JAMA
- Thyroid hormones treatment for subclinical hypothyroidism: a clinical practice guideline by Bekkering, 2019 in BMJ
- Association of subclinical hypothyroidism and cardiovascular disease with mortality by Inoue, 2020 in JAMA Netw Open
- Subclinical thyroid dysfunction and the risk of heart failure events: an individual participant data analysis from six prospective cohorts by Gencer, 2012 in J Gen Intern Med
- Evaluation of left ventricular diastolic function using tissue Doppler echocardiography and conventional doppler echocardiography in patients with subclinical hypothyroidism aged <60 years: A meta-analysis by Chen, 2013 in J Cardiol
- Echocardiographic evaluation of left ventricular diastolic dysfunction in subclinical hypothyroidism: A case-control study by Malhotra, 2017 in Endocr Res
- Atrioventricular longitudinal mechanics using novel speckle-tracking improved risk stratification beyond baseline thyroid hormone in asymptomatic subclinical hypothyroidism by Huang, 2021 in Circ Cardiovasc Imaging
- Subclinical hypothyroidism and the development of heart failure: an overview of risk and effects on cardiac function by Bielecka-Dabrowa, 2019 in Clin Res Cardiol
- Left ventricular diastolic dysfunction in patients with subclinical hypothyroidism by Biondi, 1999 in J Clin Endocrinol Metab
- The impact of levothyroxine on cardiac function in older adults with mild subclinical hypothyroidism: a randomized clinical trial by Gencer, 2020 in Am J Med
- The PRISMA 2020 statement: an updated guideline for reporting systematic reviews by Page, 2021 in BMJ
- The role of echocardiography in monitoring the therapeutic effect of levothyroxine replacement therapy in subclinical hypothyroidism by Pandrc, 2020 in Arch Biol Sci
- Calculation of left ventricular volumes and systolic indices in monitoring the therapeutic effect of levothyroxine replacement therapy in subclinical hypothyroidism by Pandrc, 2021 in Int J Clin Pract
- Left and right ventricular structure and function in subclinical hypothyroidism: The effects of one-year levothyroxine treatment by Ilic, 2013 in Med Sci Monit
- Subclinical hypothyroidism and left ventricular mechanics: A three-dimensional speckle tracking study by Tadic, 2014 in J Clin Endocrinol Metab
- The effect of L-thyroxine treatment on ventricular dysfunction and pulmonary arterial stiffness in patients with subclinical hypothyroidism by Çamci, 2022 in Eur Rev Med Pharmacol Sci
- Cardiac systolic and diastolic function at rest and exercise in subclinical hypothyroidism: Effect of thyroid hormone therapy by Arem, 1996 in Thyroid
- Estimation of left ventricular myocardial mechanics in patients with subclinical hypothyroidism using three-dimensional speckle tracking echocardiography by Chen, 2016 in J Med Imaging Health Inform
- Effect of levothyroxine on cardiac function and structure in subclinical hypothyroidism: A double blind, placebo-controlled study by Monzani, 2001 in J Clin Endocrinol Metab
- Effect of L-thyroxine treatment on left ventricular function in subclinical hypothyroidism by Franzoni, 2006 in Biomed Pharmacother BioMed Pharmacother
Citing the Source Article (APA)
(2023). Effect of thyroid hormone replacement treatment on cardiac diastolic function in adult patients with subclinical hypothyroidism: a meta-analysis. Front. Endocrinol., 14(2023). 10.3389/fendo.2023.1263861
What the Numbers Say: The Meta-Analysis
The study meticulously analyzed 17 different studies involving 568 patients. The focus was on the changes in cardiac diastolic function before and after thyroid hormone replacement therapy.
Interestingly, the study found a significant improvement in the ratios of E-velocity to A-velocity (E/A) after the therapy. However, the improvement was not complete, leaving room for further research.
Implications for the Medical Field
- Personalized Treatment Plans: The study suggests that thyroid hormone replacement therapy can be beneficial, but not a one-size-fits-all solution.
- Future Research: The partial improvement opens doors for more targeted studies.
- Risk Assessment: The study also calls for a balanced view considering the risks of overtreatment.
PP-ICONS: A Quick Evaluation
- Problem: Cardiac diastolic dysfunction in SCH patients.
- Patient or Population: Adult patients with subclinical hypothyroidism.
- Intervention: Thyroid hormone replacement therapy.
- Comparison: Pre and post-therapy cardiac function.
- Outcome: Partial improvement in cardiac diastolic function.
- Number of Subjects: 568 patients across 17 studies.
- Statistics: Significant improvement in E/A ratios.
So, what do you think about the potential of thyroid hormone replacement therapy in improving cardiac function? Is it the missing piece of the puzzle or just another variable in a complex equation? Share your thoughts below.