Both thyroid dysfunction and heart failure show a high prevalence in the adult population. Frequently, in clinical practice, a multidisciplinary approach is useful to optimize the management of patients with these conditions. Although there is no doubt regarding the close link between cardiovascular pathophysiology and thyroid homeostasis, our understanding of this association is far from being exhaustive. Thyroid hormone regulates the expression of cardiac-specific functional contractile and structural proteins and plays a pivotal role in modulating both diastolic and systolic function as well as peripheral vascular resistance. The close relationship between thyroid and heart dysfunction is strongly supported by recent evidence demonstrating that an altered thyroid profile is a negative prognostic predictor in patients with heart failure. The treatment of chronic heart failure, especially in advanced stages of the disease, continues to be an open and challenging field. The potential of novel thyroid hormone therapies that address the molecular biology of thyroid dysfunction and heart failure thus represents an attractive area of multidisciplinary scientific interest.
This book is a readable, integrated, and highly up to date presentation of the clinical, pathophysiological, and basic science aspects of thyroid - heart failure interactions. It addresses a complex subject in an approach that targets a large audience of readers.
Section I Heart Failure and Thyroid: General Aspects.- 1 Heart Failure: From Epidemiology to Pathophysiology.- 2 Neuroendocrine Control of the Cardiovascular System in Heart Failure.- 3 Cardiac Morphology and Function in Mild Hypothyroidsm.- 4 Cardiovascular Hemodynamics and Work Capacity in Thyroid Dysfunction.- Section II Basic Aspects of Thyroid Hormone and Cardiovascular System Interrelationships in Normal and in Failing Heart.- 5 Mechanism of Action of Thyroid Hormone on the Cardiac Vascular System.- 6 Cardiac Functional Effects of 3-Iodothyronamine, a New Endogenous Thyroid Hormone Derivative.- 7 Cardiac Thyroid-Hormone Deiodinative Pathways in Ventricular Hypertrophy and Heart Failure.- 8 Thyroid Hormone Receptor Signaling in Normal and Failing Heart.- 9 Pharmacological Effects of Amiodarone and Dronedarone on Cardiac Thyroid Hormone Receptors.- 10 Changes in Thyroid Hormone Metabolism and Gene Expressio in the Failing Heart: Therapeutic Implications.- 11 Thyroid Hormone Regulated Cardiac Metabolism in Normal and Failing Heart.- 12 Cardiac Myocyte and Vascular Remodeling in Altered Thyroid Conditions.- 13 Thyroid Hormone and Ischemic Myocardium.- Section III Clinical Aspects.- 14 Thyroid and Cardiovascular Risk.- 15 Relationship between Subclinical Thyroid Dysfunction and Heart Failure and Mortality.- 16 The Low Triiodothyronine Syndrome as a Powerful Predictor of Death in Heart Failure.- 17 Thyroid, Renal Function and Cardiac Outcome.- 18 Low Triiodothyronine Syndrome and Depression in Patients with Chronic Heart Failure.- Section IV Treatment: Present and Future Options.- 19 Treatment Options for Primary Thyroid Disease in Patients with Heart Failure.- 20 Synthetic Thyroid Hormone and Thyroid Hormone Analogues for Treatment of Heart Failure.- 21 Thyroid Hormone Supplementation for Infants and Children Undergoing Cardiopulmonary Bypass for Cardiac Surgery.- 22 New Approaches for Treating Heart Disease by Modulating Thyroid Hormone Signalling Using Gene Therapy Approaches