Features of left ventricular remodeling in hypothyroidism and ischemic heart disease on the background of chronic systemic inflammation

Abstract

Background. Thyroid dysfunction in modern medical science is regarded as one of the risk factors for cardiovascular diseases, unfortunately, unwittingly underestimated. It is known that even insignificant violations of thyroid function can be accompanied by the increased cardiometabolic risk. Hypothyroidism already on the early (subclinical) stage has a significant influence on formation and development of cardiovascular diseases. The results of large researches demonstrate that subclinical hypothyroidism is associated with increased risk for the development of ischemic heart disease, myocardial infarction and death rate from cardiovascular diseases. The purpose of this research is to study the structural and functional status of the left ventricular myocardium in hypothyroidism, ischemic heart di­sease and in comorbidity. Materials and methods. One hundred and forty clinical records were analyzed and 55 patients with hypothyroidism, ischemic heart disease and combined patho­logy were examined. They were divided into 3 groups: the first group — 81 patients with hypothyroidism, the second group — 67 individuals with ischemic heart disease, and the third group — 67 people with combination of hypothyroidism and ischemic heart disease. Control group included 20 persons aged 20 to 25 years. Results. It was found that myocardial hypertrophy deve­loped in all groups of patients; the decrease of thyroid function is characterized by myocardial remodeling with the development of eccentric hypertrophy, with the progression of systolic dysfunction in case of comorbidity. A direct correlation was found between reduced ejection fraction and higher levels of interleukin­8. Conclusions. Activation of chronic systemic inflammation is more significant in comorbidity, with negative prognostic influence on the state of the cardiovascular system. The decline of thyroid function results in the development of left myocardial hypertrophy with subsequent changes in cardiac geometry towards eccentric remodeling. Hypothyroidism is characterized by impaired central hemodynamics; manifestations of systolic dysfunction are increased in combination of thyroid pathology and ischemic heart disease. Activation of chronic systemic inflammation is more significant in comorbidity, with negative prognostic influence on the state of the cardiovascular system.

Keywords

• thyroid gland
• heart, hypothyroidism
• myocardial hypertrophy
• left ventricle
• proinflammatory cytokines