Thyroid Status in Patients after Acute Myocardial Infarction

1984 ◽  
Vol 67 (6) ◽  
pp. 585-590 ◽  
Author(s):  
J. A. Franklyn ◽  
M. D. Gammage ◽  
D. B. Ramsden ◽  
M. C. Sheppard
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Thyroid Status ◽  
Free T4 ◽  
Thyroxine Binding Globulin ◽  
Free T3 ◽  
Total Thyroxine

1. Subjects followed serially after acute myocardial infarction demonstrated a rapid and sustained fall in serum total tri-iodothyronine (T3) concentration and a rise in reverse tri-iodothyronine (rT3) concentration. There was a transient fall in total thyroxine (T4) concentration. 2. Thyroxine binding globulin (TBG) levels were unchanged after acute myocardial infarction but prolonged falls were observed in thyroxine binding prealbumin (TBPA) and albumin concentrations. 3. In contrast to the fall in total T4, both measured and calculated free T4 concentrations were unchanged but measured and calculated free T3 concentrations fell as did total T3. 4. Despite the observed fall in T3, basal thyrotrophin (TSH) concentrations did not rise. 5. The reduction in circulating T3 levels after acute myocardial infarction suggests that a hypothyroid state exists. Until tissue thyroid status can be assessed directly, however, this conclusion must remain in doubt.

scholarly journals Prevalence of Subclinical Hypothyroidism among Patients with Acute Myocardial Infarction

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Okuyan Ertugrul ◽  
Uslu Ahmet ◽  
Enhos Asim ◽  
Hepgul E. Gulcin ◽  
Ayca Burak ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Subclinical Hypothyroidism ◽  
Large Scale ◽  
Thyroid Stimulating Hormone ◽  
Free T4 ◽  
Upper Limit ◽  
St Elevation ◽  
Elevation Acute Myocardial Infarction ◽  
Tsh Levels

Introduction. Subclinical hypothyroidism (SCH) is defined as a serum thyroid-stimulating hormone (TSH) level above the upper limit of normal despite normal levels of serum free thyroxine. There is growing evidence that SCH is associated with increased cardiovascular risk. We tried to investigate prevalence of SCH in acute myocardial infarction patients. Methods and Results. We evaluate free T3, free T4, and TSH levels of 604 patients (age 58.4) retrospectively, who have been admitted to the coronary intensive care unit between years 2004–2009 with the diagnosis of ST elevation (STEMI) or non-ST elevation acute myocardial infarction (NSTEMI). Mild subclinical hypothyroidism (TSH 4.5 to 9.9 mU/l) was present in 54 (8.94%) participants and severe subclinical hypothyroidism (TSH 10.0 to 19.9 mU/l) in 11 (1.82%). So 65 patients (10.76%) had TSH levels between 4.5 and 20. Conclusions. In conclusion, 65 patients (10.76%) had TSH levels between 4.5 and 20 in our study, and it is a considerable amount. Large-scale studies are needed to clarify the effects of SCH on myocardial infarction both on etiologic and prognostic grounds.

Effect of Sodium Ethylmercurithiosalicylate (Thimerosal) on Serum Binding of Thyroid Hormones

1973 ◽  
Vol 51 (2) ◽  
pp. 156-159 ◽  
Author(s):  
Diego Bellabarba ◽  
Raymonde Tremblay
Keyword(s):  
Thyroid Hormones ◽  
Binding Proteins ◽  
Serum Proteins ◽  
Free Fraction ◽  
Inhibitory Effect ◽  
Free T4 ◽  
Thyroxine Binding Globulin ◽  
Free T3 ◽  
Serum Binding Protein ◽  
Barbital Buffer

Sodium ethylmercurithiosalicylate (Thimerosal, Merthiolate) has been found to interfere with the binding of thyroid hormones to serum proteins. Dialysis studies showed that this compound, added to serum in concentrations varying from 90 to 360 mg/100 ml, caused an increase of the dialyzable or free fraction of thyroxine (T4) and triiodothyronine (T3). The increase was higher for the free T4 (3.8- to 18-fold) than for the free T3 fraction (2.3- to 5-fold). Electrophoretic studies on the distribution of tracer amounts of labeled T4 among the serum binding proteins revealed that the inhibitory effect of sodium ethylmercurithiosalicylate was exerted mainly on thyroxine binding globulin (TBG). In presence of this compound (180 mg/100 ml of serum) the percentage of tracer T4 bound to TBG was reduced from 53% to 9%. These findings were also confirmed by examining the binding of tracer amounts of labeled T4 and T3 in a serum diluted in barbital buffer, which inhibits the hormonal binding to thyroxine binding prealbumin and albumin. In presence of sodium ethylmercurithiosalicylate a significant displacement of both T4 and T3 from the serum binding protein (TBG) was observed.

scholarly journals Tyhroid Storm-Induced Worsening Acute Myocardial Infarction: A Case Report

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A314-A314
Author(s):  
Sonya Farah Diba
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Epigastric Pain ◽  
Thyroid Storm ◽  
Left Main ◽  
Free T4 ◽  
High Grade Fever ◽  
Severe Nausea ◽  
Typical Chest Pain

Abstract Background: As a true endocrine emergency, thyroid storm is rarely associated with acute myocardial infarction. However Graves’ disease is the most common underlying cause of thyroid storm. Clinical Case: A 47-year women experienced typical chest pain since 30 minutes before visited emergency room. The patient had type two diabetes as a cardiovascular risk factor and regularly took metformin thrice daily. The electrocardiogram showed non-ST segment elevation in leads I, V4-V6. Coronary arteriography showed stenosis in the three and left main vessels (70% stenosis of right coronary, 80% stenosis of left circumflex, 90% stenosis of left anterior descendent, and 90% stenosis of mid distal, in left main stem) then the patient was planned to do bypass surgery. At day 6 of hospitalization, the typical chest pain was worsening, epigastric pain became more painful, had 5 times diarrhea per day, high grade fever (>38.5oC), severe nausea and vomiting, then generalized tonic clonic seizure and respiratory failure was occurred. The patient was intubated in intensive care unit. Through a detail physical examination, a diffuse palpable thyroid enlargement and class I ophthalmopathy were found. Laboratory findings of free T4 was 2.23 ng/dL and Thyroid Stimulating Hormone (TSH) was 0.003 µIU/mL. The patient was assessed as thyroid storm then immediately, treated with three times of 100 mg hydrocortisone, two times of 20 mg of propranolol, and three times of 400 mg propylthiourasil. The patient’s clinical appearance was gradually recovered. After 3 days of treatment, she was extubated from ventilator. Two weeks later, no complaint of chest pain or epigastric pain in observation. Conclusion: Our case highlight the possibility that hyperthyroidism may be involved in the development of acute myocardial infarction.

scholarly journals About connection of clinical manifestations of glomerulonephritis with features of the thyroid status of patients

2020 ◽  
Vol 66 (2) ◽  
pp. 13-23
Author(s):  
Louise M. Karzakova ◽  
Olga I. Avtonomova ◽  
Sergey I. Kudryashov ◽  
Nadezhda D. Ukhterova ◽  
Nadezhda А. Komelyagina
Keyword(s):  
Thyroid Gland ◽  
Inflammatory Cytokine ◽  
Clinical Manifestations ◽  
Thyroid Status ◽  
Free T4 ◽  
Free T3 ◽  
Clinical Variant ◽  
Clinical Variants ◽  
Anti Inflammatory ◽  
Anti Inflammatory Cytokine

BACKGROUND: There are four clinical variants of glomerulonephritis (GN) - urinary (latent), hypertensive, nephrotic and mixed. It was found that the features of clinical manifestations of GN that determine its clinical variant do not depend on the etiology, pathogenesis and morphological form of the disease. Taking into account the obtained data on the association of nephrotic syndrome with hypofunction of the thyroid gland, we suggested, that the formation of clinical variants of GN may be influenced by the features of the thyroid status of patients. AIM: Study the relationship of variants of clinical manifestations of GN with indicants of thyroid status. MATERIALS AND METHODS: The study included patients with primary GN who received in-treatment in the nephrology unit of a general hospital. Patients were selected into 4 groups depending on the clinical variant of GN (urinary, nephrotic, hypertensive and mixed variants). When selecting patients, we achieved comparability of groups by age, gender, morphological variants and duration of the disease. In addition to the generally accepted methods of research, patients were performed: 1) assessment of the thyroid status (thyroid-stimulating hormone (TSH), free thyroxine (free T4), free triiodothyronine (free T3), antibodies to thyroperoxidase (anti-TPO), (free T3+free T4)/TSH, free T4/free T3, free T4/TSH); 2) determination of levels of interleukin - IL-1, IL-4 and IL-10 in blood serum; 3) ultrasound (US) examination of the thyroid gland. The obtained data were compared with those of healthy people. RESULTS: The group of patients with the nephrotic variant of GN in 50% of cases showed a decrease of the level of free Т4 with the increase of TSH level, 26.7% showed a moderate increase of TSH at unchanged concentrations of free Т4 and free T3. In patients with the urinary variant of GN, the thyroid status did not differ from that in healthy patients, and the cytokine profile was characterized by a simultaneous increase in the content of the proinflammatory cytokine IL-1 and the anti-inflammatory cytokine IL-10. The group of patients with the hypertonic variant of GN in 82% of cases showed an isolated increase in TSH content. In the group of patients with a mixed variant of GN, changes in thyroid indices were predominant, combined with a large variability in the level of IL-1 production. CONCLUSIONS: The results of the study indicate the influence of the functional state of the pituitary-thyroid system on the formation of different clinical variants of GN, which depends mainly on the level of production of the anti-inflammatory cytokine IL-10.

scholarly journals THYROID STATUS IN CHILDREN WITH TYPE 1 DIABETES MELLITUS

2021 ◽  
Vol 06 (01) ◽  
pp. 71-72
Author(s):  
Zhanar Nurgaliyeva Zhanar Nurgaliyeva ◽  
Araily Manasbaeva Araily Manasbaeva ◽  
Sakhipzhamal Sabirova Sakhipzhamal Sabirova ◽  
Saiyara Nadyrova Saiyara Nadyrova ◽  
Alfira Muratkhan Alfira Muratkhan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Thyroid Hormone ◽  
Autoimmune Thyroiditis ◽  
Laboratory Data ◽  
Thyroid Status ◽  
Free T4 ◽  
Hormone Levels ◽  
Functional Changes ◽  
Free T3 ◽  
Thyroid Hormone Levels

The mutually aggravating effect of comorbid diseases of diabetes mellitus (DM) and autoimmune thyroiditis (AIT) is of scientific interest to researchers. Timely assessment of the thyroid status in children with DM and correction of thyroid pathology (TP) will improve metabolic control in these patients. Аmong 972 children with DM, 478 (49.2%) were assessed for thyroid status. It is noted that every year the determination of thyroid hormone levels in children increased from 7.6% (in 2014) to 92.1% (in 2019). Among 478 examined children, 319 (66.7%) had significantly revealed thyroid dysfunction. In the structure of thyroid pathologies, the frequency of hypothyroidism was 12.5% (in 11.3% - subclinical form), hyperthyroidism - 4%. functional changes in the concentration of thyroid hormones as Euthyroid sick syndrome were observed in 23.8%. The most common type of dysfunction was an isolated increase in free T3 (isolated T3 toxicosis) – in 43.3% of cases. In 2 cases out of 18 (0.6%), a complete picture of AIT was presented, and in the remaining 16 (5.1%), signs of AIT were observed only on ultrasound of the thyroid gland, and were not confirmed by the concentrations of anti-TPO Ab, anti-TG Ab. In 47 (14.7%) children, laboratory data on thyroid hormone levels showed elevated values of TSH, free T3, free T4. Keywords: children, diabetes mellitus, thyroid status, autoimmune thyroiditis

An electron microscopic study of the intra-myocardial lesions in cases of acute myocardial infarction

1978 ◽  
Vol 36 (2) ◽  
pp. 484-485
Author(s):  
Masahiro Ono ◽  
Kaoru Aihara ◽  
Gompachi Yajima
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Vessels ◽  
Vascular Wall ◽  
Vascular Changes ◽  
Electron Microscopic ◽  
Main Trunk ◽  
Mechanical Destruction ◽  
Transmission Electron ◽  
Myocardial Lesions

The pathogenesis of the arteriosclerosis in the acute myocardial infarction is the matter of the extensive survey with the transmission electron microscopy in experimental and clinical materials. In the previous communication,the authors have clarified that the two types of the coronary vascular changes could exist. The first category is the case in which we had failed to observe no occlusive changes of the coronary vessels which eventually form the myocardial infarction. The next category is the case in which occlusive -thrombotic changes are observed in which the myocardial infarction will be taken placed as the final event. The authors incline to designate the former category as the non-occlusive-non thrombotic lesions. The most important findings in both cases are the “mechanical destruction of the vascular wall and imbibition of the serous component” which are most frequently observed at the proximal portion of the coronary main trunk.

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