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Abstract(s)
Introdução: O papel da glândula tiroide na homeostasia é vital para o ótimo
funcionamento do sistema cardiovascular. Sabendo que as hormonas tiroideias
desempenham um impacto significativo na função cardíaca, alterações na mesma são
expectáveis na presença de distúrbios tiroideus, sendo estes um fator de risco para o
desenvolvimento de insuficiência cardíaca, importante problema de saúde a nível
mundial
Objetivos: Esta revisão tem como objetivo principal analisar os dados bibliográficos
atuais sobre o impacto e as implicações clínicas da disfunção tiroideia em doentes com
insuficiência cardíaca.
Métodos: Para a elaboração desta monografia, procedeu-se à pesquisa de artigos na
plataforma PubMed (https://pubmed.ncbi.nlm.nih.gov), com as seguintes palavraschave: thyroid AND heart failure AND outcomes.
Resultados: Foram analisados 12 artigos que abordavam a relação entre a presença
de hipotiroidismo e hipertiroidismo (clínico ou subclínico) e síndrome de
triiodotironina baixa e desfechos adversos em pacientes com insuficiência cardíaca
(aguda ou crónica, descompensada ou não). Na generalidade, a síndrome de
triiodotironina baixa e o hipotiroidismo subclínico foram associados a piores
prognósticos, como maior taxa de mortalidade e rehospitalização. Relativamente aos
restantes casos de hipotiroidismo e de hipertiroidismo os resultados são díspares,
reportando-se tanto a presença, como a ausência de associação com eventos adversos.
Um dos estudos não encontrou nenhuma relação entre o diagnóstico de patologia
tiroideia e risco aumentado de morte.
Conclusão: Os estudos analisados apresentaram resultados divergentes quanto ao
papel prognóstico da disfunção tiroideia na insuficiência cardíaca, pelo que são
necessários mais estudos relativamente a esta problemática, de modo a esclarecer o
conhecimento científico acerca deste tema e, consequentemente, reduzir a
variabilidade dos dados publicados. Contudo, esta pesquisa permitiu concluir que
níveis reduzidos de triiodotironina livre e síndrome de triiodotironina baixa são
preditores de desfechos adversos, em doentes com insuficiência cardíaca, pelo que a
triiodotironina livre pode desempenhar um papel útil enquanto marcador de
prognóstico nestes pacientes. O hipotiroidismo subclínico, parece também associarse a um mau prognóstico na insuficiência cardíaca.
Introduction: The role of the thyroid gland in homeostasis is vital for the optimal functioning of the cardiovascular system. Knowing that thyroid hormones have a significant impact on cardiac function, changes in these levels are expected in the presence of thyroid disorders, a known risk factor for the development of heart failure, which represents an important health problem worldwide. Aims: The main objective of this review is to analyze current bibliographic data on the impact and clinical implications of thyroid dysfunction in patients with heart failure. Methods: This work was based on the research of scientific articles on the PubMed platform (https://pubmed.ncbi.nlm.nih.gov), with the following keywords: thyroid AND heart failure AND outcomes. Results: This study analyzed 12 articles that addressed the relationship between adverse outcomes in patients with heart failure (acute or chronic, decompensated or not) and the presence of hypothyroidism or hyperthyroidism (clinical or subclinical) or low triiodothyronine syndrome. In general, low triiodothyronine syndrome and subclinical hypothyroidism were associated with worse prognosis, such as higher rates regarding mortality and rehospitalization. Regarding the remaining cases of hypothyroidism and hyperthyroidism, the results are mixed, reporting both the presence and absence of association with adverse events. One of the studies did not find any relationship between the diagnosis of thyroid disease and an increased risk of death. Conclusion: The analyzed studies showed divergent results regarding the prognostic role of thyroid dysfunction in heart failure, therefore more studies are needed on this issue, in order to clarify the scientific knowledge on this topic and, consequently, reduce the variability of published data. However, this research led to the conclusion that reduced levels of free triiodothyronine and low triiodothyronine syndrome are predictors of adverse outcomes in patients with heart failure, so free triiodothyronine may play a useful role as a prognostic marker in these patients. Subclinical hypothyroidism also seems to be associated with a poor prognosis in heart failure.
Introduction: The role of the thyroid gland in homeostasis is vital for the optimal functioning of the cardiovascular system. Knowing that thyroid hormones have a significant impact on cardiac function, changes in these levels are expected in the presence of thyroid disorders, a known risk factor for the development of heart failure, which represents an important health problem worldwide. Aims: The main objective of this review is to analyze current bibliographic data on the impact and clinical implications of thyroid dysfunction in patients with heart failure. Methods: This work was based on the research of scientific articles on the PubMed platform (https://pubmed.ncbi.nlm.nih.gov), with the following keywords: thyroid AND heart failure AND outcomes. Results: This study analyzed 12 articles that addressed the relationship between adverse outcomes in patients with heart failure (acute or chronic, decompensated or not) and the presence of hypothyroidism or hyperthyroidism (clinical or subclinical) or low triiodothyronine syndrome. In general, low triiodothyronine syndrome and subclinical hypothyroidism were associated with worse prognosis, such as higher rates regarding mortality and rehospitalization. Regarding the remaining cases of hypothyroidism and hyperthyroidism, the results are mixed, reporting both the presence and absence of association with adverse events. One of the studies did not find any relationship between the diagnosis of thyroid disease and an increased risk of death. Conclusion: The analyzed studies showed divergent results regarding the prognostic role of thyroid dysfunction in heart failure, therefore more studies are needed on this issue, in order to clarify the scientific knowledge on this topic and, consequently, reduce the variability of published data. However, this research led to the conclusion that reduced levels of free triiodothyronine and low triiodothyronine syndrome are predictors of adverse outcomes in patients with heart failure, so free triiodothyronine may play a useful role as a prognostic marker in these patients. Subclinical hypothyroidism also seems to be associated with a poor prognosis in heart failure.
Description
Keywords
Disfunção Tiroideia Hipertiroidismo Hipotiroidismo Implicações Clínicas Insuficiência Cardíaca Síndrome de T3 Baixa