That was the question asked in a study led by researchers from the Heart Center/State University of New York (SUNY) in Stony Brook, New York. The goal was to evaluate the effect of thyroid dysfunction on structure and function of the left-heart chambers and blood markers of cardiac disease. The results of the cross-sectional analysis were published in the Journal of Clinical Endocrinology & Metabolism.
The participants came from the Cardiovascular Health Study, a community-based cohort of older individuals recruited from four urban areas in the United States. Of the 3,163 participants studied, 2,477 were euthyroid, 465 had subclinical hypothyroidism (SCH), 47 had overt hypothyroidism (OH), 45 had endogenous subclinical hyperthyroidism (endo-SCT), and 129 had exogenous subclinical hyperthyroidism (exo-SCT) due to thyroid hormone supplementation, based on clinical evaluation, blood sampling, and biomarker measurement, as well as two-dimensional and speckle-tracking echocardiography.
The main outcome measures were defined as left heart myocardial deformation, circulating biomarkers of diastolic overload (NT-proBNP), fibrosis (sST2, gal-3), and cardiomyocyte injury (hs-cTnT).
The results indicated that SCH was associated with higher NT-proBNP (beta = 0.17; P = .004), while OH was associated with higher hs-cTnT (beta = 0.29, P = .005).
“There were also suggestive associations of SCH with higher sST2, as well as endo-SCT with higher gal-3 and lower (worse) left atrial reservoir strain,” the authors advised. “Left ventricular longitudinal strain and end-diastolic strain rate did not differ significantly from euthyroid participants in SCH, OH, or exo-SCT.”
Study authors concluded, “In this free-living elderly cohort, subclinical and overt hypothyroidism were associated with abnormalities of blood biomarkers consistent with diastolic overload and myocardial necrosis respectively, whereas subclinical hyperthyroidism tended to be associated with myocardial fibrosis and decreased left atrial strain.”
They pointed out that their findings “could represent stage B heart failure and illuminate distinct aspects of the pathobiology of heart disease related to thyroid gland dysfunction with potential clinical implications.”
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