Медицинская литература. Новинки

 

 

 

 

 

 

ЩИТОВИДНАЯ ЖЕЛЕЗА И СЕРДЦЕ

Вы можете загрузить полный текст статьи в формате pdf

Изменения со стороны сердечно-сосудистой системы являются наиболее частыми при нарушении функции щитовидной железы. Понимание механизмов действия гормонов щитовидной железы на кардиоваскулярную систему может объяснить изменения сердечного выброса, сердечной сократимости, артериального давления, нарушения ритма, связанные с дисфункцией щитовидной железы. В данном обзоре представлены современные данные об изменениях сердечно-сосудистой системы, возникающих при тиреотоксикозе и гипотиреозе, а также изменения со стороны щитовидной железы на фоне хронической сердечно-сосудистой недостаточности.

Ключевые слова:
щитовидная железа, тиреотоксикоз, гипотиреоз, сердце.

Литература:
1. Canaris G.J., Manowitz N.R., Mayor G., Ridgway E.C. The
Colorado thyroid disease prevalence study // Arch. Intern. Med.
2000. V. 160. P. 526–530.
2. Biondi B., Palmieri E.A., Lombardi G., Fazio S. Effects of thyroid
hormone on cardiac function: the relative importance of heart rate,
loading conditions, and myocardial contractility in the regulation
of cardiac performance in human hyperthyroidism // J. Clin.
Endocrinol. Metab. 2002. V. 87. P. 968–974.
3. Everts M.E., Verhoeven F.A., Bezstarosti K. et al. Uptake of thyroid
hormones in neonatal rat cardiac myocytes // Endocrinol. 1996.
V. 137. P. 4235–4242.
4. Klein I., Danzi S. Thyroid Disease and the Heart // Circulat. 2007.
V. 116. P. 1725–1735
5. Klein I., Ojamaa K. Thyroid hormone and the cardiovascular system // N. Engl. J. Med. 2001. V. 344. P. 501–509.
6. Danzi S., Klein I. Thyroid hormone and the cardiovascular system
// Minerva Endocrinologica. 2004. V. 29. P. 139–150.
7. Petersen P., Hansen J.M. Stroke in thyrotoxicosis with atrial fibrillation // Stroke. 1988. V. 19. P. 15–18.
8. Krahn A.D., Klein G.J., Kerr C.R. et al. How useful is thyroid function testing in patients with recentonset atrial fibrillation? The
Canadian Registry of Atrial Fibrillation Investigators // Arch.
Intern. Med. 1996. V. 156. P. 2221–2224.
9. Duntas L.H. Thyroid disease and lipids. Thyroid. 2002. V. 12.
P. 287–293.
10. Nakazawa H.K., Sakurai K., Hamada N., Momotani N., Ito K.
Management of atrial fibrillation in the postthyrotoxic state //
Am. J. Med. 1982. V. 72. P. 903–906.
11. Gilligan D.M., Ellenbogen K.A., Epstein A.E. The management of
atrial fibrillation // Am. J. Med. 1996. V. 101. P. 413–421.
12. Sawin C.T., Geller A., Wolf P.A. et al. Low serum thyrotropin concentrations as a risk factor for atrial fibrillation in older persons //
N. Engl. J. Med. 1994. V. 331. P. 1249–1252
13. Biondi B., Fazio S., Carella C. et al. Control of adrenergic overactivity by betablockade improves the quality of life in patients
receiving longterm suppressive therapy with levothyroxine //
J. Clin. Endocrinol. Metab. 1994. V. 78. P. 1028–1033.
14. Forfar J.C., Muir A.L., Sawers S.A., Toft A.D. Abnormal left ventricular function in hyperthyroidism: evidence for possible
reversible cardiomyopathy // N. Engl. J. Med. 1982. V. 307.
P. 1165–1170.
15. Шульгина В.Ю., Фадеев В.В., Мельниченко Г.А. Поражение
миокарда при тиреотоксикозе: особенности течения, исходы,
отдаленный прогноз // Клин. и экспер. тиреоидол. 2006. Т. 2.
№ 4. С. 21–30.
16. Kahaly G., MohrKahaly S., Hellermann // J. Heart. Thyroid.
Wien. 1994.
17. Kahaly G. Graves’ disease and mitral valve prolapse // JAMA.
1987. V. 257. P. 22–28.
18. Klein I., Ojamaa K. The cardiovascular system in hypothyroidism /
In: L.E. Braverman, R.D. Utiger // Eds. Werner & Ingbar’s the
thyroid: a fundamental and clinical text. 8th ed. Philadelphia:
Lippincott Williams & Wilkins, 2000. P. 777–782.
19. Bengel F.M., Nekolla S.G., Ibrahim T. Effect of thyroid hormones
on cardiac function, geometry, and oxidative metabolism assessed
noninvasively by positron emission tomography and magnetic resonance imaging // J. Clin. Endocrinol. Metab. 2000. V. 85.
P. 1822–1827.
20. Ojamaa K., Sabet A., Kenessey A. et al. Regulation of rat cardiac
Kv1.5 gene expression by thyroid hormone is rapid and chamber
specific // Endocrinol. 1999. V. 140. P. 3170–3176.
21. Cooper D., Halpern R., Wood L.C. et al. Lthyroxine therapy in
subclinical hypothyroidism: a doubleblind, placebocontrolled
trial // Ann. Intern. Med. 1984. V. 101. P. 18–24.
22. Hak A.E., Pols H.A.P, Visser T.J. et al. Subclinical hypothyroidism
is an independent risk factor for atherosclerosis and myocardial
infarction in elderly women: the Rotterdam Study // Ann. Intern.
Med. 2000. C. 132. P. 270–278.
23. Franklyn J.A., Gammage M.D., Ramsden D.B., Sheppard M.C.
Thyroid status in patients after acute myocardial infarction // Clin.
Sci (Colch). 1984. V. 67. P. 585–590.
24. Hamilton M.A., Stevenson L.W., Fonarow G.C. et al. Safety and
hemodynamic effects of intravenous triiodothyronine in advanced
congestive heart failure // Am. J. Cardiol. 1998. V. 81. P. 443–447.
25. Moruzzi P., Doria E., Agostoni P.G. Mediumterm effectiveness of
Lthyroxine treatment in idiopathic dilated cardiomyopathy //
Am. J. Med. 1996. V. 101. P. 461–467.
26. Holland F.W., Brown P.S.Jr., Weintraub B.D., Clark R.E.
Cardiopulmonary bypass and thyroid function: a “euthyroid sick
syndrome” // Ann. Thorac. Surg. 1991. V. 52. P. 46–50.
27. Novitzky D., Fontanet H., Snyder M. et al. Impact of triiodothyronine on the survival of highrisk patients undergoing open heart
surgery // Cardiology. 1996. V. 87. P. 509–515.
28. Cimochowski G.E., Harostock M.D., Foldes P.J. Minimal operative
mortality in patients undergoing coronary artery bypass with significant left ventricular dysfunction by maximization of metabolic
and mechanical support // Thorac. Cardiovasc. Surg. 1997. V. 113.
P. 655–666.
29. Klemperer J.D., Klein I.L., Ojamaa K. et al. Triiodothyronine therapy the incidence of atrial fibrillation after cardiac operations //
Ann. Thorac. Lowers. Surg. 1996. V. 61. P. 1323–1329.
30. MullisJanson S.L., Argenziano M., Corwin S. et al. A randomized
double blind study of the effect of triiodothyronine on cardiac
function and morbidity after coronary bypass surgery // J. Thor.
Cardiovasc. Surg. 1999. V. 117. P. 1128–1134.
31. BennettGuerrero E., Jimenez J.L., White W.D. et al. Cardiovascular effects of intravenous triiodothyronine in patients undergoing coronary artery bypass graft surgery: a randomized, doubleblind, placebo-controlled trial // JAMA. 1996. V. 275. P. 687–692.
32. Bettendorf M., Schmidt K.G., Tiefenbacher U. et al. Transient secondary hypothyroidism in children after cardiac surgery // Pediatr.
Res. 1997. V. 41. P. 375–379.
33. Saatvedt K., Lindberg H. Depressed thyroid function following pediatric cardiopulmonary bypass: association with interleukin-6
release? Scand // J. Thorac. Cardiovasc. Surg. 1996. V. 30. P. 61–64.
34. Mainwaring R.D., Lamberti J.J., Carter T.L.Jr., Nelson J.C.
Reduction in triiodothyronine levels following modified Fontan
procedure // J. Card. Surg. 1994. V. 9. P. 322–331.
35. Chowdhury D., Parnell V., Ojamaa K. et al. Usefulness of triiodothyronine treatment after surgery for complex congenital heart
disease in infants and children // Am. J. Cardiol. 1999. V. 84.
P. 1107–1109.

Thyroid and the Heart

The cardiovascular signs and symptoms of thyroid disease are some of the most clinically relevant findings that accompany both hyperthyroidism and hypothyroidism. On the basis of the understanding of the mechanisms of thyroid hormone action on the heart and cardiovascular system, it is possible to explain the changes in cardiac output, cardiac contractility, blood pressure and rhythm disturbances that result from thyroid dysfunction. In the present review will integrate what is known about the mechanisms of thyroid hormone action on the heart and the alterations in thyroid hormone metabolism that accompany chronic congestive heart failure.

Keywords:
thyroid gland, hyperthyroidism, hypothyroidism, heart.