Myocardial Inactivation of Thyroid Hormones in Patients with Aortic Stenosis
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Citações na Scopus
8
Tipo de produção
article
Data de publicação
2017
Editora
MARY ANN LIEBERT, INC
Indexadores
Título da Revista
ISSN da Revista
Título do Volume
Autores
PREITE, Nailliw Z.
BIANCO, Antonio C.
Autor de Grupo de pesquisa
Editores
Coordenadores
Organizadores
Citação
THYROID, v.27, n.5, p.738-745, 2017
Resumo
Objective: The human heart expresses the type 2 deiodinase (D2) that activates thyroxine (T4) to triiodothyronine (T3). At the same time, the inactivating type 3 deiodinase (D3) has been found in a rat model of right ventricular hypertrophy. It is not known whether the human myocardium metabolizes thyroid hormone. This study examined myocardial thyroid hormone metabolism in patients with aortic valve stenosis (AS) undergoing aortic valve replacement and in patients with coronary artery disease (CAD) undergoing coronary artery bypass grafting surgery. Methods: Myocardial thyroid hormone metabolism was assessed by analyzing the difference in serum thyroid hormone levels between the aortic root (incoming blood) and the coronary sinus (outgoing blood) of patients undergoing cardiac surgery. A total of 23 patients with AS and 35 patients with CAD were included. Patients received a pre-surgical echocardiogram, and pre-, during and post-surgical thyroid hormone serum levels were collected in the myocardial and peripheral circulations. Results: Patients with AS exhibited the expected left ventricle (LV) hypertrophy (i.e., 20-30% increase in LV posterior wall and interventricular septum thickness and similar to 10% increase in AS in LV diastolic diameter). Immediately before cardiopulmonary bypass, blood flowing through the AS myocardium exhibited a 4.6% reduction in T3 and 6.9% increase in rT3 levels, decreasing the serum T3/rT3 ratio by 9.6%. T4 and thyrotropin serum levels remained similar between the aortic root and coronary sinus. In contrast, no myocardial thyroid hormone metabolism was observed in CAD patients. Notably, the AS myocardium lost the ability to inactivate thyroid hormone after cardiopulmonary bypass, possibly due to myocardial stunning. Conclusions: There is accelerated thyroid hormone inactivation in the AS myocardium, which is likely the result of D3 expression. No evidence to suggest thyroid hormone activation in the myocardium was obtained in the present study.
Palavras-chave
euthyroid sick syndrome, deiodinases, thyroid hormones, aortic stenosis, heart surgery
Referências
- Abdalla SM, 2014, CLIN ENDOCRINOL, V81, P633, DOI 10.1111/cen.12538
- Carvalho-Bianco SD, 2004, MOL ENDOCRINOL, V18, P1840, DOI 10.1210/me.2003-0125
- Chowdhury D, 1999, AM J CARDIOL, V84, P1107, DOI 10.1016/S0002-9149(99)00513-5
- Croteau W, 1996, J CLIN INVEST, V98, P405, DOI 10.1172/JCI118806
- Freitas BCG, 2010, J CLIN INVEST, V120, P2206, DOI 10.1172/JCI41977
- Gereben B, 2008, ENDOCR REV, V29, P898, DOI 10.1210/er.2008-0019
- Hong EG, 2013, ENDOCRINOLOGY, V154, P3937, DOI 10.1210/en.2012-2261
- Klemperer JD, 1996, ANN THORAC SURG, V61, P1323, DOI 10.1016/0003-4975(96)00102-6
- Klemperer JD, 2002, THYROID, V12, P517, DOI 10.1089/105072502760143917
- KLEMPERER JD, 1995, NEW ENGL J MED, V333, P1522, DOI 10.1056/NEJM199512073332302
- Olivares EL, 2007, ENDOCRINOLOGY, V148, P4786, DOI 10.1210/en.2007-0043
- Pachucki J, 2001, ENDOCRINOLOGY, V142, P13, DOI 10.1210/endo.142.1.7907
- Paparella D, 2002, EUR J CARDIO-THORAC, V21, P232, DOI 10.1016/S1010-7940(01)01099-5
- Peeters RP, 2005, J CLIN ENDOCR METAB, V90, P6498, DOI 10.1210/jc.2005-1013
- Peeters RP, 2003, J CLIN ENDOCR METAB, V88, P3202, DOI 10.1210/jc.2002-022013
- Pingitore A, 2008, J CLIN ENDOCR METAB, V93, P1351, DOI 10.1210/jc.2007-2210
- Pol CJ, 2011, ENDOCRINOLOGY, V152, P669, DOI 10.1210/en.2010-0431
- Rosene ML, 2010, ENDOCRINOLOGY, V151, P5961, DOI 10.1210/en.2010-0553
- Salvatore D, 1996, ENDOCRINOLOGY, V137, P3308, DOI 10.1210/en.137.8.3308
- Simonides WS, 2008, J CLIN INVEST, V118, P975, DOI 10.1172/JCI32824
- Trivieri MG, 2006, P NATL ACAD SCI USA, V103, P6043, DOI 10.1073/pnas.0601072103
- Ueta CB, 2012, MOL ENDOCRINOL, V26, P809, DOI 10.1210/me.2011-1325
- Vassallo P, 2007, JAMA-J AM MED ASSOC, V298, P1312, DOI 10.1001/jama.298.11.1312
- Wang YY, 2010, CARDIOVASC RES, V87, P636, DOI 10.1093/cvr/cvq133
- Wassen FWJS, 2002, ENDOCRINOLOGY, V143, P2812, DOI 10.1210/en.143.7.2812
- Zahler S, 1999, CARDIOVASC RES, V41, P722, DOI 10.1016/S0008-6363(98)00229-6
Coleções
Artigos e Materiais de Revistas Científicas - FM/MCP
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/11
Artigos e Materiais de Revistas Científicas - LIM/42
Artigos e Materiais de Revistas Científicas - ODS/03
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/11
Artigos e Materiais de Revistas Científicas - LIM/42
Artigos e Materiais de Revistas Científicas - ODS/03