Effect of Short-Term L-Thyroxine Therapy on Left Ventricular Mechanics in Idiopathic Dilated Cardiomyopathy
Previous experimental studies have provided evidence of notable changes in thyroid hormone signaling that corresponds to alterations in myocardial function in animal models of heart failure (HF). The present study further explores whether oral thyroid hormone treatment can change left ventricular (L...
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| Veröffentlicht in: | Journal of the American Society of Echocardiography 2020-10, Vol.33 (10), p.1234-1244 |
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| creator | Badran, Hala Mahfouz Faheem, Naglaa Zidan, Amr Yacoub, Magdi H. Soltan, Ghada |
| description | Previous experimental studies have provided evidence of notable changes in thyroid hormone signaling that corresponds to alterations in myocardial function in animal models of heart failure (HF). The present study further explores whether oral thyroid hormone treatment can change left ventricular (LV) mechanics and functional status in patients with idiopathic dilated cardiomyopathy (IDCM) or not.
Sixty IDCM patients who were receiving conventional HF treatment were randomized to oral L-thyroxine (n = 40) or placebo (n = 20) for 3 months. Fifty-two (86.7%) of all IDCM patients were symptomatic, their mean age was 41 ± 12 years, and their ejection fraction was 32% ± 7%. At baseline, the two groups were comparable in clinical and echocardiographic variables. Vector velocity imaging was utilized to assess LV mechanics. Myocardial longitudinal peak systolic strain, systolic strain rate, early and late diastolic strain rate, circumferential strain, LV dyssynchrony, plasma tri-iodothyronine, thyroxine, and thyroid stimulating hormone levels were measured at baseline and 3 months after treatment.
All patients receiving L-thyroxine significantly improved in functional status (New York Heart Association class; P |
| doi_str_mv | 10.1016/j.echo.2020.05.009 |
| format | Article |
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Sixty IDCM patients who were receiving conventional HF treatment were randomized to oral L-thyroxine (n = 40) or placebo (n = 20) for 3 months. Fifty-two (86.7%) of all IDCM patients were symptomatic, their mean age was 41 ± 12 years, and their ejection fraction was 32% ± 7%. At baseline, the two groups were comparable in clinical and echocardiographic variables. Vector velocity imaging was utilized to assess LV mechanics. Myocardial longitudinal peak systolic strain, systolic strain rate, early and late diastolic strain rate, circumferential strain, LV dyssynchrony, plasma tri-iodothyronine, thyroxine, and thyroid stimulating hormone levels were measured at baseline and 3 months after treatment.
All patients receiving L-thyroxine significantly improved in functional status (New York Heart Association class; P < .001) and echocardiographic parameters including end-diastolic diameter (P < .001), end-systolic diameter (P < .001), mitral regurgitation severity reduction (P < .001), and increased ejection fraction (P < .001). Left ventricular mechanics showed marked improvement at segmental and global levels of both longitudinal and circumferential myocardial strain (P < .005) when compared with placebo group.
Short-term L-thyroxine therapy is well tolerated in IDCM patients. It improves cardiac mechanics and functional status, which might support the potential role of synthetic thyroid hormones in HF treatment.
•Adding Oral T4 for 3 months to HF treatment improves patient functional status.•L-thyroxine helps LV reverse remodeling in IDCM without changing TH levels.•Oral T4 improves cardiac mechanics in circumferential and longitudinal direction.•Short-term T4 can be added safely to HF treatment without adverse effects.]]></description><identifier>ISSN: 0894-7317</identifier><identifier>EISSN: 1097-6795</identifier><identifier>DOI: 10.1016/j.echo.2020.05.009</identifier><identifier>PMID: 32792320</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Idiopathic dilated cardiomyopathy ; L-thyroxine ; LV mechanics</subject><ispartof>Journal of the American Society of Echocardiography, 2020-10, Vol.33 (10), p.1234-1244</ispartof><rights>2020 American Society of Echocardiography</rights><rights>Copyright © 2020 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-1eed1f10d7ff308c4fc19cb3fdfa9a28d631b73bb3a881f58847d14299dbc5b43</citedby><cites>FETCH-LOGICAL-c356t-1eed1f10d7ff308c4fc19cb3fdfa9a28d631b73bb3a881f58847d14299dbc5b43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.echo.2020.05.009$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32792320$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Badran, Hala Mahfouz</creatorcontrib><creatorcontrib>Faheem, Naglaa</creatorcontrib><creatorcontrib>Zidan, Amr</creatorcontrib><creatorcontrib>Yacoub, Magdi H.</creatorcontrib><creatorcontrib>Soltan, Ghada</creatorcontrib><title>Effect of Short-Term L-Thyroxine Therapy on Left Ventricular Mechanics in Idiopathic Dilated Cardiomyopathy</title><title>Journal of the American Society of Echocardiography</title><addtitle>J Am Soc Echocardiogr</addtitle><description><![CDATA[Previous experimental studies have provided evidence of notable changes in thyroid hormone signaling that corresponds to alterations in myocardial function in animal models of heart failure (HF). The present study further explores whether oral thyroid hormone treatment can change left ventricular (LV) mechanics and functional status in patients with idiopathic dilated cardiomyopathy (IDCM) or not.
Sixty IDCM patients who were receiving conventional HF treatment were randomized to oral L-thyroxine (n = 40) or placebo (n = 20) for 3 months. Fifty-two (86.7%) of all IDCM patients were symptomatic, their mean age was 41 ± 12 years, and their ejection fraction was 32% ± 7%. At baseline, the two groups were comparable in clinical and echocardiographic variables. Vector velocity imaging was utilized to assess LV mechanics. Myocardial longitudinal peak systolic strain, systolic strain rate, early and late diastolic strain rate, circumferential strain, LV dyssynchrony, plasma tri-iodothyronine, thyroxine, and thyroid stimulating hormone levels were measured at baseline and 3 months after treatment.
All patients receiving L-thyroxine significantly improved in functional status (New York Heart Association class; P < .001) and echocardiographic parameters including end-diastolic diameter (P < .001), end-systolic diameter (P < .001), mitral regurgitation severity reduction (P < .001), and increased ejection fraction (P < .001). Left ventricular mechanics showed marked improvement at segmental and global levels of both longitudinal and circumferential myocardial strain (P < .005) when compared with placebo group.
Short-term L-thyroxine therapy is well tolerated in IDCM patients. It improves cardiac mechanics and functional status, which might support the potential role of synthetic thyroid hormones in HF treatment.
•Adding Oral T4 for 3 months to HF treatment improves patient functional status.•L-thyroxine helps LV reverse remodeling in IDCM without changing TH levels.•Oral T4 improves cardiac mechanics in circumferential and longitudinal direction.•Short-term T4 can be added safely to HF treatment without adverse effects.]]></description><subject>Idiopathic dilated cardiomyopathy</subject><subject>L-thyroxine</subject><subject>LV mechanics</subject><issn>0894-7317</issn><issn>1097-6795</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kE1v1DAQhi0EotvCH-CAfOSSMP7IxpG4oG2hlRb10C1Xy7HHipckXuwsIv--WbZw5DTS6HlfzTyEvGNQMmDrj_sSbRdLDhxKqEqA5gVZMWjqYl031UuyAtXIohasviCXOe8BoFIAr8mF4HXDBYcV-XHjPdqJRk8fupimYodpoNti180p_g4j0l2HyRxmGke6RT_R7zhOKdhjbxL9thxgxmAzDSO9cyEezNQFS69DbyZ0dGPSshzmP_v5DXnlTZ_x7fO8Io9fbnab22J7__Vu83lbWFGtp4IhOuYZuNp7AcpKb1ljW-GdN43hyq0Fa2vRtsIoxXyllKwdk7xpXGurVoor8uHce0jx5xHzpIeQLfa9GTEes-ZSSKkqqWBB-Rm1Keac0OtDCoNJs2agT5L1Xp8k65NkDZVeJC-h98_9x3ZA9y_y1-oCfDoDuHz5K2DS2QYcLbqQFtnaxfC__idNXI7k</recordid><startdate>202010</startdate><enddate>202010</enddate><creator>Badran, Hala Mahfouz</creator><creator>Faheem, Naglaa</creator><creator>Zidan, Amr</creator><creator>Yacoub, Magdi H.</creator><creator>Soltan, Ghada</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202010</creationdate><title>Effect of Short-Term L-Thyroxine Therapy on Left Ventricular Mechanics in Idiopathic Dilated Cardiomyopathy</title><author>Badran, Hala Mahfouz ; Faheem, Naglaa ; Zidan, Amr ; Yacoub, Magdi H. ; Soltan, Ghada</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-1eed1f10d7ff308c4fc19cb3fdfa9a28d631b73bb3a881f58847d14299dbc5b43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Idiopathic dilated cardiomyopathy</topic><topic>L-thyroxine</topic><topic>LV mechanics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Badran, Hala Mahfouz</creatorcontrib><creatorcontrib>Faheem, Naglaa</creatorcontrib><creatorcontrib>Zidan, Amr</creatorcontrib><creatorcontrib>Yacoub, Magdi H.</creatorcontrib><creatorcontrib>Soltan, Ghada</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Society of Echocardiography</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Badran, Hala Mahfouz</au><au>Faheem, Naglaa</au><au>Zidan, Amr</au><au>Yacoub, Magdi H.</au><au>Soltan, Ghada</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of Short-Term L-Thyroxine Therapy on Left Ventricular Mechanics in Idiopathic Dilated Cardiomyopathy</atitle><jtitle>Journal of the American Society of Echocardiography</jtitle><addtitle>J Am Soc Echocardiogr</addtitle><date>2020-10</date><risdate>2020</risdate><volume>33</volume><issue>10</issue><spage>1234</spage><epage>1244</epage><pages>1234-1244</pages><issn>0894-7317</issn><eissn>1097-6795</eissn><abstract><![CDATA[Previous experimental studies have provided evidence of notable changes in thyroid hormone signaling that corresponds to alterations in myocardial function in animal models of heart failure (HF). The present study further explores whether oral thyroid hormone treatment can change left ventricular (LV) mechanics and functional status in patients with idiopathic dilated cardiomyopathy (IDCM) or not.
Sixty IDCM patients who were receiving conventional HF treatment were randomized to oral L-thyroxine (n = 40) or placebo (n = 20) for 3 months. Fifty-two (86.7%) of all IDCM patients were symptomatic, their mean age was 41 ± 12 years, and their ejection fraction was 32% ± 7%. At baseline, the two groups were comparable in clinical and echocardiographic variables. Vector velocity imaging was utilized to assess LV mechanics. Myocardial longitudinal peak systolic strain, systolic strain rate, early and late diastolic strain rate, circumferential strain, LV dyssynchrony, plasma tri-iodothyronine, thyroxine, and thyroid stimulating hormone levels were measured at baseline and 3 months after treatment.
All patients receiving L-thyroxine significantly improved in functional status (New York Heart Association class; P < .001) and echocardiographic parameters including end-diastolic diameter (P < .001), end-systolic diameter (P < .001), mitral regurgitation severity reduction (P < .001), and increased ejection fraction (P < .001). Left ventricular mechanics showed marked improvement at segmental and global levels of both longitudinal and circumferential myocardial strain (P < .005) when compared with placebo group.
Short-term L-thyroxine therapy is well tolerated in IDCM patients. It improves cardiac mechanics and functional status, which might support the potential role of synthetic thyroid hormones in HF treatment.
•Adding Oral T4 for 3 months to HF treatment improves patient functional status.•L-thyroxine helps LV reverse remodeling in IDCM without changing TH levels.•Oral T4 improves cardiac mechanics in circumferential and longitudinal direction.•Short-term T4 can be added safely to HF treatment without adverse effects.]]></abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>32792320</pmid><doi>10.1016/j.echo.2020.05.009</doi><tpages>11</tpages></addata></record> |
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| subjects | Idiopathic dilated cardiomyopathy L-thyroxine LV mechanics |
| title | Effect of Short-Term L-Thyroxine Therapy on Left Ventricular Mechanics in Idiopathic Dilated Cardiomyopathy |
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