Left Ventricular Function in Hypothyroidism. Responses to Exercise and Beta Adrenoceptor Blockade

Overview

Journal Br Heart J

Specialty Cardiology & Vascular Diseases

Date 1982 Sep 1

PMID 7104121

Citations 8

Authors

J C Forfar

A L Muir

A D Toft

Affiliations

Soon will be listed here.

Abstract

The effects of exercise and beta adrenoceptor blockade on left ventricular function were assessed in eight patients with hypothyroidism before and during thyroxine replacement treatment. Left ventricular ejection fraction, measured by radionuclide ventriculography, was reduced in hypothyroid patients at rest and on exercise. The rise in ejection fraction with exercise was, however, similar in both groups. Pretreatment with intravenous propranolol reduced the ejection fraction at rest 9% in both hypothyroid and euthyroid patients and reduced the rise on exercise. Directional changes in a second index of myocardial contractility based on the shape of the ventricular volume curve paralleled the changes in the ejection fraction. Left ventricular function is therefore reversibly depressed by thyroid hormone deficiency but responses to exercise and beta adrenoceptor blockade are normal. There is no evidence of altered adrenergic sensitivity in the control of myocardial contractility in hypothyroidism.

Citing Articles

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References

SONNENBLICK E, Braunwald E, WILLIAMS Jr J, Glick G . Effects of exercise on myocardial force-velocity relations in intact unanesthetized man: relative roles of changes in heart rate, sympathetic activity, and ventricular dimensions. J Clin Invest. 1965; 44(12):2051-62. PMC: 289708. DOI: 10.1172/JCI105312. View

Vanhaelst L, Neve P, Chailly P, Bastenie P . Coronary-artery disease in hypothyroidism. Observations in clinical myxoedema. Lancet. 1967; 2(7520):800-2. DOI: 10.1016/s0140-6736(67)92235-0. View

Amidi M, LEON D, deGroot W, Kroetz F, Leonard J . Effect of the thyroid state on myocardial contractility and ventricular ejection rate in man. Circulation. 1968; 38(2):229-39. DOI: 10.1161/01.cir.38.2.229. View

Taylor R, Covell J, ROSS Jr J . Influence of the thyroid state on left ventricular tension-velocity relations in the intact, sedated dog. J Clin Invest. 1969; 48(4):775-84. PMC: 322282. DOI: 10.1172/JCI106035. View

Steinberg A . Myxedema and coronary artery disease--a comparative autopsy study. Ann Intern Med. 1968; 68(2):338-44. DOI: 10.7326/0003-4819-68-2-338. View

Coltart D, SHAND D . Plasma propranolol levels in the quaniitative assessment of beta-adrenergic blockade in man. Br Med J. 1970; 3(5725):731-4. PMC: 1701661. DOI: 10.1136/bmj.3.5725.731. View

Helfant R, Herman M . Abnormalities of left ventricular contraction induced by beta adrenergic blockade. Circulation. 1971; 43(5):641-7. DOI: 10.1161/01.cir.43.5.641. View

Irvine W, Toft A, Hunter W, KIRKHAM K . An assessment of plasma TSH radioimmunoassay and of the TSH stimulation test in the diagnosis of 100 consecutive patients with suspected hypothyroidism. Clin Endocrinol (Oxf). 1973; 2(2):135-9. DOI: 10.1111/j.1365-2265.1973.tb00413.x. View

Frishman W, Smithen C, Befler B, Kligfield P, Killip T . Noninvasive assessment of clinical response to oral propranolol therapy. Am J Cardiol. 1975; 35(5):635-44. DOI: 10.1016/0002-9149(75)90049-1. View

10.

Shubrooks Jr S, Zir L, Dinsmore R, HARTHORNE J . Left ventricular wall motion response to intravenous propranolol. Circulation. 1975; 52(1):124-9. DOI: 10.1161/01.cir.52.1.124. View

11.

Croxson M, IBBERTSON H . Serum digoxin in patients with thyroid disease. Br Med J. 1975; 3(5983):566-8. PMC: 1674491. DOI: 10.1136/bmj.3.5983.566. View

12.

Seth J, Toft A, Irvine W . Simple solid-phase radioimmunoassays for total tri-iodothyronine and thyroxine in serum, and their clinical evaluation. Clin Chim Acta. 1976; 68(3):291-301. DOI: 10.1016/0009-8981(76)90394-6. View

13.

Crowley Jr W, Ridgway E, Bough E, Francis G, Daniels G, Kourides I . Noninvasive evaluation of cardiac function in hypothyroidism. Response to gradual thyroxine replacement. N Engl J Med. 1977; 296(1):1-6. DOI: 10.1056/NEJM197701062960101. View

14.

Strauer B, Schulze W . Experimental hypothyroidism: depression of myocardial contractile function and hemodynamics and their reversibility by substitution with thyroid hormones. Basic Res Cardiol. 1976; 71(6):624-44. DOI: 10.1007/BF01906408. View

15.

Ciaraldi T, Marinetti G . Thyroxine and propylthiouracil effects of vivo on alpha and beta adrenergic receptors in rat heart. Biochem Biophys Res Commun. 1977; 74(3):984-91. DOI: 10.1016/0006-291x(77)91615-1. View

16.

Bell J, Russell C, Nelson J, Kelly J, McDevitt D . Studies of the effect of thyroid dysfunction on the elimination of beta-adrenoreceptor blocking drugs. Br J Clin Pharmacol. 1977; 4(1):79-82. PMC: 1428989. DOI: 10.1111/j.1365-2125.1977.tb00672.x. View

17.

Muir A, Hannan W, Brash H, Baldwa V, Miller H, Ogilvie B . The assessment of left ventricular ejection fraction in patients with ischaemic heart disease by contrast ventriculography and nuclear angiography. Clin Sci Mol Med. 1977; 53(1):55-61. DOI: 10.1042/cs0530055. View

18.

Harrower A, Fyffe J, Horn D, Strong J . Thyroxine and triiodothyronine levels in hyperthyroid patients during treatment with propranolol. Clin Endocrinol (Oxf). 1977; 7(1):41-4. DOI: 10.1111/j.1365-2265.1977.tb02938.x. View

19.

Burger A, NICOD P, Suter P, Vallotton M, Vagenakis P, Braverman L . Reduced active thyroid hormone levels in acute illness. Lancet. 1976; 1(7961):653-5. DOI: 10.1016/s0140-6736(76)92774-4. View

20.

KAPLAN M, UTIGER R . Iodothyronine metabolism in rat liver homogenates. J Clin Invest. 1978; 61(2):459-71. PMC: 372557. DOI: 10.1172/JCI108957. View