TRIIODOTHYRONINE (T3) AND CARDIOVASCULAR THERAPEUTICS - A REVIEW

被引:35
作者
SALTER, DR [1 ]
DYKE, CM [1 ]
WECHSLER, AS [1 ]
机构
[1] VIRGINIA COMMONWEALTH UNIV MED COLL VIRGINIA,DEPT SURG,SANGER HALL,ROOM 8015,RICHMOND,VA 23219
关键词
TRIIODOTHYRONINE; HEMODYNAMICS; HYPOTHYROIDISM; CARDIOPULMONARY BYPASS; EUTHYROID SICK SYNDROME;
D O I
10.1111/j.1540-8191.1992.tb01029.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Hypothyroidism is associated with an abnormal hemodynamic state characterized by decreased heart rate, stroke volume, output, and contractility, and increased systemic vascular resistance. Since cardiopulmonary bypass (CPB) and surgical stress can induce profound decreases in triiodothyronine (T3) levels, the hemodynamic consequences of "stress-induced" hypothyroidism and T3 repletion are of increasing clinical interest. Available data generally support the likelihood of a beneficial effect associated with T3 replacement in brain-dead organ donors and in cases of low cardiac output following CPB. Although hypotheses have been advanced to account for these salutary effects, the mechanism by which T3 may augment hemodynamic performance has not been precisely defined, particularly in the acute setting. Although additional research is needed to clarify these and other issues, preliminary findings with T3 replacement indicate that such investigation is warranted.
引用
收藏
页码:363 / 374
页数:12
相关论文
共 52 条
[1]  
Dillmann WH, Biochemical basis of thyroid hormone action on the heart, Am J Med, 88, (1990)
[2]  
Preedy JRK, Clements SD, Delcher HK, The heart and endocrine diseases, The Heart, (1986)
[3]  
Chu S-H, Huang T-S, Hsu R-B, Et al., Thyroid hormone changes after cardiovascular surgery and clinical implications, Ann Thorac Surg, 52, (1991)
[4]  
Bremner WF, Taylor KM, Baird S, Et al., Hypothalamo‐pituitary‐thyroid axis function during cardiopulmonary bypass, J Thorac Cardiovasc Surg, 75, (1978)
[5]  
Robuschi G, Medici D, Fesani F, Et al., Cardiopulmonary bypass: “A low T<sub>4</sub> and T<sub>3</sub> syndrome” with blunted thyrotropin (TSH) response to thyrotropin‐releasing hormone (TRH), Horm Res, 23, (1986)
[6]  
Holland FW, Brown PS, Weintraub BD, Et al., Cardiopulmonary bypass and thyroid function: A “euthyroid sick syndrome, Ann Thorac Surg, 52, (1991)
[7]  
Novitzky D, Cooper DKC, Swanepoel A, Inotropic effect of triiodothyronine (T<sub>3</sub>) in low cardiac output following cardioplegic arrest and cardiopulmonary bypass: An initial experience in patients undergoing open heart surgery, Eur J Cardiothorac Surg, 3, (1989)
[8]  
Mitchell IM, Pollock JC, Jamieson MP, Et al., The effects of cardiopulmonary bypass on thyroid function in infants weighing less than five kilograms, J Thorac Cardiovasc Surg, 103, (1992)
[9]  
Haynes RC, Thyroid and antithyroid drugs, Goodman and Gilman's The Pharmacological Basis of Therapeutics, (1990)
[10]  
Wartofsky L, Ingbar SH, Diseases of the thyroid, Harrison's Principles of Internal Medicine, (1991)