You are here
Subclinical thyroid dysfunction, cardiac function, and the risk of heart failure. The Cardiovascular Health study.
Tuesday,2012-11-06 12:10 America/Los_Angeles — eenright
| Title | Subclinical thyroid dysfunction, cardiac function, and the risk of heart failure. The Cardiovascular Health study. |
| Publication Type | Journal Article |
| Year of Publication | 2008 |
| Authors | Rodondi, N, Bauer, DC, Cappola, AR, Cornuz, J, Robbins, J, Fried, LP, Ladenson, PW, Vittinghoff, E, Gottdiener, JS, Newman, AB |
| Journal | J Am Coll Cardiol |
| Volume | 52 |
| Issue | 14 |
| Pagination | 1152-9 |
| Date Published | 2008 Sep 30 |
| ISSN | 1558-3597 |
| Keywords | Aged, Aged, 80 and over, Cohort Studies, Echocardiography, Female, Heart, Heart Failure, Heart Function Tests, Humans, Hyperthyroidism, Hypertrophy, Left Ventricular, Hypothyroidism, Male, Risk Factors, Time Factors |
| Abstract | <p><b>OBJECTIVES: </b>The goal of this study was to determine whether subclinical thyroid dysfunction was associated with incident heart failure (HF) and echocardiogram abnormalities.</p><p><b>BACKGROUND: </b>Subclinical hypothyroidism and hyperthyroidism have been associated with cardiac dysfunction. However, long-term data on the risk of HF are limited.</p><p><b>METHODS: </b>We studied 3,044 adults>or=65 years of age who initially were free of HF in the Cardiovascular Health Study. We compared adjudicated HF events over a mean 12-year follow-up and changes in cardiac function over the course of 5 years among euthyroid participants, those with subclinical hypothyroidism (subdivided by thyroid-stimulating hormone [TSH] levels: 4.5 to 9.9, >or=10.0 mU/l), and those with subclinical hyperthyroidism.</p><p><b>RESULTS: </b>Over the course of 12 years, 736 participants developed HF events. Participants with TSH>or=10.0 mU/l had a greater incidence of HF compared with euthyroid participants (41.7 vs. 22.9 per 1,000 person years, p=0.01; adjusted hazard ratio: 1.88; 95% confidence interval: 1.05 to 3.34). Baseline peak E velocity, which is an echocardiographic measurement of diastolic function associated with incident HF in the CHS cohort, was greater in those patients with TSH>or=10.0 mU/l compared with euthyroid participants (0.80 m/s vs. 0.72 m/s, p=0.002). Over the course of 5 years, left ventricular mass increased among those with TSH>or=10.0 mU/l, but other echocardiographic measurements were unchanged. Those patients with TSH 4.5 to 9.9 mU/l or with subclinical hyperthyroidism had no increase in risk of HF.</p><p><b>CONCLUSIONS: </b>Compared with euthyroid older adults, those adults with TSH>or=10.0 mU/l have a moderately increased risk of HF and alterations in cardiac function but not older adults with TSH<10.0 mU/l. Clinical trials should assess whether the risk of HF might be ameliorated by thyroxine replacement in individuals with TSH>or=10.0 mU/l.</p> |
| DOI | 10.1016/j.jacc.2008.07.009 |
| Alternate Journal | J Am Coll Cardiol |
| PubMed ID | 18804743 |
| PubMed Central ID | PMC2874755 |
| Grant List | N01 HC085086 / HC / NHLBI NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States N01 HC-55222 / HC / NHLBI NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States |