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Thyroid Hormone Abnormalities in Myocardial Infarction

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Thyroid and Heart

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Abstract

The low T3 syndrome is characterized by low serum T3 and fT3 and normal T4, fT4, and TSH levels, in the absence of intrinsic thyroid disease and can be seen after an acute myocardial infarction in about 15–20% of cases. It is also seen in acute and chronic illness, sepsis, and after surgery, including cardiac, under cardiopulmonary bypass. It is caused by inflammation and cytokine action and increased ROS production, as well as altered deiodinase (DIO) activity (upregulation of DIO3 and downregulation of DIO1), which affect thyroid hormone action on the peripheral tissues. Thus, the actions of these hormones on the myocardium (contractility) and on peripheral vessels (vasodilation) are blunted. Low T3 levels after myocardial infarction are associated with a worse prognosis; however, the effectiveness of thyroid hormone supplementation is still under discussion, since only results from small trials after cardiac surgery and myocardial infarction are available.

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Authors and Affiliations

  1. Second Department of Cardiology, General Hospital of Nikea-Piraeus ‘Agios Panteleimon’, Piraeus, Greece

    Dimitrios Varvarousis

  2. Cardiology Department, Biomedical Research Foundation Academy of Athens, Athens, Greece

    Stavros Chryssanthopoulos & Dennis V. Cokkinos

  3. First Department of Cardiology, Evagelismos General Hospital of Athens, Athens, Greece

    Kali Polytarchou

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  1. Dimitrios Varvarousis
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  3. Kali Polytarchou
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  4. Dennis V. Cokkinos
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Correspondence to Dennis V. Cokkinos .

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  1. Institute of Clinical Physiology (IFC) National Research Council (CNR), Pisa, Italy

    Giorgio Iervasi

  2. Institute of Clinical Physiology (IFC) National Research Council (CNR), Pisa, Italy

    Alessandro Pingitore

  3. NYITCOM College of Osteopathic Medicine Biomedical Sciences Department, Old Westbury, NY, USA

    A.Martin Gerdes

  4. Institute of Clinical and Translational Medicine, Newcastle University/Queen Elizabeth Hospital, Newcastle upon Tyne, UK

    Salman Razvi

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Varvarousis, D., Chryssanthopoulos, S., Polytarchou, K., Cokkinos, D.V. (2020). Thyroid Hormone Abnormalities in Myocardial Infarction. In: Iervasi, G., Pingitore, A., Gerdes, A., Razvi, S. (eds) Thyroid and Heart . Springer, Cham. https://doi.org/10.1007/978-3-030-36871-5_21

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