Hypothyroidism and subclinical hypothyroidism and their influence on autonomic cardiovascular regulation and metabolism
M. Bacelova1, M. Popova1, A. Alakidi2
- Medical University of Plovdiv, Bulgaria
- Medical University of Sofia, Bulgaria
DOI: https://doi.org/10.15407/fz69.01.077
![](/images/cite.png)
Abstract
The aim of this review is to expose different opinions in the literature on the influence of TH and TSH on
the autonomic vegetative regulation of cardiovascular function and metabolism in marked and subclinical
hypothyroidism (sHT). Hypothyroidism causes changes in hemodynamics and in lipid metabolism,
which are predisposing risk factors for cardiovascular diseases. Subclinical hypothyroidism proceeds
asymptomatically but there are changes in the cardiovascular system and its regulation, as well as a possible
need for hormonal treatment. Although according to literature sources the social and age groups studied
are heterogeneous and different tests have been used to investigate the autonomic vegetative regulation,
no single model for investigation and therapeutic behavior, especially in sHT, has yet been established.
Heart rate variability (HRV) is determined by the balance of afferent sympathetic and parasympathetic
influences on cardiac structures and can be used for risk stratification of cardiovascular complications in
patients with hypothyroidism. Early detection of autonomic dysfunction and its treatment may improve the
overall prognosis as well as the quality of life of patients with hypothyroidism and sHT and limit the rates
of cardiovascular morbidity and mortality in these patients.
Keywords:
hypothyroidism; subclinical hypothyroidism; autonomic cardiovascular regulation; heart rate variability
References
- Bivolarska А, Gatseva P, Maneva А. Association between thyroid and iron status of pregnant women in southern Bulgaria. J Endocrinol Diabet Mellitus. 2013;1:15-21. ISSN 2310-9971.
- Bivolarska A, Gatseva P, Argirova M. Study on urinary iodine and thiocyanate concentrations in Bulgarian schoolchildren and students. In: Iodine-characteristics, sources and health implications, eds. A.H. Martinez, E.J. Perez, Nova Sci Inc. NY;2012.109-19. ISBN 978-1-61942- 708-2. In: Advances in Medicine and Biology, vol.50, eds. L. Berhardt, Nova Science Inc, NY; 2012:183-94.
- Bivolarska A, Gatseva P, Vlaykova T. Environmental factors stimulating the manifestation of iodine deficiency disorders: A study on pregnant women. In Book Series: Adv in Med Biol, vol.80, eds. L.Berhardt. Nova Science Inc, NY; 2014: 129-44. (eBook).
- Bivolarska A, Gatseva P, Atanasova V, Kalev S, Tchervenkov B. Urinary iodine and thiocyanate concentration in Bulgarian young mothers. Trakia J Sci. 2014;12(1): 61-4.
- Bivolarska A, Maneva A, Gatseva P, Katsarova M. Impact of nitrates, thiocyanates and selenium on the iron and iodine status of postpartum women. Folia Med. 2016;58(3):188-94.
CrossRef
PubMed
- Bivolarska А, Gatseva P, Maneva A. Comparative evaluation of iodine status of children from endemic and non-endemic district in South Bulgaria on the background of successful iodine prevention. Sci Technol - Intern online J Union Sci -St. Zagora, Bulgaria. 2013;3(1):317-21.
- Bivolarska A, P Gatseva, Nikolova J, Argirova M, Atanasova V. Effect of thiocyanate on iodine status of pregnant women. Biol Trace Elem Res. 2015;1-7.
CrossRef
PubMed
- Chiovato L, Flavia Magri, Allan Carlé. Hypothyroidism in context: Where we've been and where we're going. Adv Ther. 2019; 36(Suppl 2): 47-58.
CrossRef
PubMed PubMedCentral
- Udovcic M, Pena RH, Patham B, Tabatabai L, Kansara A. Hypothyroidism and the hear. Methodist Debakey Cardiovascul J. Apr-Jun 2017;13(2):55-9.
CrossRef
PubMed PubMedCentral
- Fabio G, Franzoni F, Fallahi P, Tocchini L, Braccini L, Santoro G, Antonelli A. Changes in heart rate variability and QT dispersion in patients with overt hypothyroidism. Eur J Endocrinol. 2008;158: 85-90.
CrossRef
PubMed
- Walsh JP, Bremner AP, Bulsara MK, O'Leary P, Leedman PJ, Feddema P, et al. Subclinical thyroid function and blood pressure: a community-based study. Clin Endocrinol. 2006;65:486-91.
CrossRef
PubMed
- Moldabek G. Heart rate variability indicators in patients with hypothyroidism. Mhsj. 2011;6(2):127-31.
CrossRef
- Heemstra KA, Burggraaf J, vander Klaauw AA, Romijn JA, Smit JW, Corssmit EP. Short term overt hypothyroidism induces sympathovagal imbalance in thyroidectomized differentiated thyroid carcinoma patients. Clin Endocrinol. 2010;72:417-21.
CrossRef
PubMed
- Feldstein S, Stevo J. The complex interaction between overweight, hypertension, and sympathetic overactivity. J Am Soc Hypertens. 2009; 3(6):353-65.
CrossRef
PubMed
- Millis M, Austin E, Bond V, Faruque M, Goring KL, Hickey BM, Blakely R, De Meersman RE. Effects of high-carbohydrate and high-fat dietary treatments on measures of heart rate variability and sympathovagal balance. Life Sci. 2009; 85(3-4):141-45.
CrossRef
PubMed
- Danilowich-Szymanowicz L. The effect of anaerobic and aerobic tests on autonomic nervous system activity in healthy young athletes. Biol Sport. 2010; 27:65-9.
CrossRef
- Kumar PR, Pandey S, Chittawar S, Shrivastav K. A comparative study of cardiac autonomic function tests in hypothyroid patients and euthyroid subjects. Natl J Physiol Pharm Pharmacol. 2021;11(1): 37-40.
CrossRef
- Schesser J. BME 333 biomedical signals and systems. An introduction to signals and systems, Stuller, Thomson. HRV Analysis; 2013.
- Shokr Elsayed AM, Rasheed AA, Mohamed KA Abdallah FA, Mohamed IA. Physiological study on the relation of heart rate variability in ageing and thyroid hormone disorder. Int J Med Res Health Sci. 2016;5(4):133-8.
- Xing H, Shen Y, Chen H, Wang Y, Shen W. Heart rate variability and its response to thyroxine replacement therapy in patients with hypothyroidism. Chin Med J (Engl). Sep2001;114(9):906-8.
- Cacciatori V, Gemma ML, Bellavere F, Castello R, De Gregori ME, Zoppini G, et al. Power spectral analysis of heart rate in hypothyroidism. Eur J Endocrinol. 2000;143:327-33.
CrossRef
PubMed
- Kaminski Grzegorz, Karol Makowski, Dariusz Michałkiewicz, Jarosław Kowal, Marek Ruchala, Ewelina Szczepanek, Grzegorz Gielerak. The influence of subclinical hyperthyroidism on blood pressure, heart rate variability, and prevalence of arrhythmias. Thyroid. 2012 May;22(5):454-60.
CrossRef
PubMed
|