Decreased adrenergic sensitivity in patients with hypothyroidism

Details

Serval ID
serval:BIB_E901D4E8BF9E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Decreased adrenergic sensitivity in patients with hypothyroidism
Journal
Journal of the American College of Cardiology
Author(s)
Polikar  R., Kennedy  B., Maisel  A., Ziegler  M., Smith  J., Dittrich  H., Nicod  P.
ISSN
0735-1097 (Print)
Publication state
Published
Issued date
01/1990
Volume
15
Number
1
Pages
94-8
Notes
Journal Article
Research Support, U.S. Gov't, P.H.S. --- Old month value: Jan
Abstract
Cardiovascular sensitivity to catecholamines was assessed in 15 patients with hypothyroidism (mean [+/- SEM] thyroxine [T4] index 2.7 +/- 0.5 micrograms/100 ml, thyroid stimulating hormone [TSH] 136.9 +/- 48.3 microU/ml), aged 45 +/- 4 years and in 8 healthy control subjects. The study was repeated in 10 patients with hypothyroidism 4.0 +/- 0.5 months after thyroid replacement therapy (T4 index 9.9 +/- 2.1 micrograms/100 ml, TSH 3.5 +/- 1.3 microU/ml). In addition, basal, average and maximal heart rates were measured using 24 h ambulatory electrocardiographic (ECG) monitoring, and plasma levels of epinephrine and norepinephrine were determined before and after thyroid replacement. Heart rate increased less after bolus injection of 0.8, 1.6 and 3.2 micrograms of isoproterenol in the hypothyroid (10 +/- 2, 15 +/- 2 and 21 +/- 4 beats/min, respectively) than in the euthyroid (16 +/- 3, 22 +/- 3 and 30 +/- 4 beats/min, respectively) state (p less than 0.05). Control subjects reacted similarly to patients receiving thyroid replacement. Basal heart rate (64 +/- 3 versus 68 +/- 3 beats/min, p less than 0.05) and maximal heart rate (116 +/- 5 versus 133 +/- 5 beats/min, p less than 0.05) were lower on 24 h ambulatory ECG monitoring in the hypothyroid than euthyroid state despite higher basal plasma norepinephrine levels (394 +/- 45 versus 315 +/- 45 pg/ml, p less than 0.05). Thus, patients with hypothyroidism display a decreased cardiac chronotropic response to beta-adrenergic stimulation. This may contribute in part to the decreased basal and maximal daily heart rates seen in patients with hypothyroidism, which occurs despite elevated plasma norepinephrine levels.
Keywords
Adrenergic beta-Agonists/*pharmacology Electrocardiography, Ambulatory Epinephrine/blood Female Heart Rate/*drug effects Humans Hypothyroidism/drug therapy/*physiopathology Isoproterenol/*pharmacology Male Middle Aged Norepinephrine/blood Stimulation, Chemical Thyroxine/therapeutic use
Pubmed
Web of science
Open Access
Yes
Create date
25/01/2008 14:00
Last modification date
20/08/2019 16:11
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