Specific impact of cardiovascular risk factors on coronary microcirculation in patients with subclinical hypothyroidism

Coronary in subclinical hypothyroidism

  • Mirjana Stojković Clinic of endocrinology, diabetes and metabolic disease, University Clinical Center of Serbia
  • Biljana Nedeljković-Beleslin 1. Faculty of Medicine, University od Belgrade 2. Clinic of Endocrinology, Diabetes and Metabolic diseases, Clinical Center of Serbia
  • Milorad Tesic Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia 3. Clinic for Cardiology Clinical Center of Serbia
  • Zoran Bukumiric 1. Faculty of Medicine, University od Belgrade 4. Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade
  • Jasmina Ciric 1. Faculty of Medicine, University od Belgrade 2. Clinic of Endocrinology, Diabetes and Metabolic diseases, Clinical Center of Serbia
  • Milos Stojanovic Stojanovic 1. Faculty of Medicine, University od Belgrade 2. Clinic of Endocrinology, Diabetes and Metabolic diseases, Clinical Center of Serbia
  • Marija Miletic 1. Faculty of Medicine, University od Belgrade 2. Clinic of Endocrinology, Diabetes and Metabolic diseases, Clinical Center of Serbia
  • Ana Djordjevic-Dikic Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia 3. Clinic for Cardiology Clinical Center of Serbia
  • Vojislav Giga Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia 3. Clinic for Cardiology Clinical Center of Serbia0
  • Branko Beleslin Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia 3. Clinic for Cardiology Clinical Center of Serbia
  • Milos Zarkovic 1. Faculty of Medicine, University od Belgrade 2. Clinic of Endocrinology, Diabetes and Metabolic diseases, Clinical Center of Serbia
DOI: https://doi.org/10.5937/jomb0-34545
Keywords: cardiovascular risk factors, coronary flow reserve, subclinical hypothyroidism, thyroid

Abstract


Background: Although thyroid hormones have significant effect on cardiovascular system, the impact of subtle thyroid dysfunction such as subclinical hypothyroidism (SCH) remains to be determined. We investigated coronary flow reserve (CFR) in patients with subclinical hypothyroidism.

Methods: Thirty-two subjects with SCH and eighteen control subjects with normal serum thyroid hormones and thyroid-stimulating hormone (TSH) levels were included in the study. TSH, free thyroxine, free triiodothyronine, glucose, insulin, HbA1c, cholesterol, triglyceride and plasma levels of C-reactive protein were measured. Coronary diastolic peak flow velocities in left anterior descending coronary artery were measured at baseline and after adenosine infusion. CFR was calculated as the ratio of hyperemic to baseline diastolic peak velocity.

Results: CFR values were not significantly different between the two groups (SCH 2.76 ± 0.35 vs controls 2.76 ± 0.42). There was a significant correlation of CFR with waist to hip ratio, hypertension, smoking habits, markers of glucose status (glucose level, HbA1c, insulin level, HOMA IR), cholesterol, LDL-cholesterol and triglyceride levels in SCH group, whereas only cholesterol level showed significant correlation with CFR in controls. There was no correlation between CFR and thyroid hormones.

Conclusion: We concluded that there is a different impact of cardiovascular risk factors on CFR in SCH patients compared to healthy control and that these two groups behave differently in the same circumstances under the same risk factors. The basis for this difference could be that the altered thyroid axis “set point” changes the sensitivity of the microvasculature in patients with SCH to known risk factors.

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Published
2021/12/03
Issue
Vol. 41 No. 3 (2022): Journal of Medical Biochemistry
Section
Original paper

Copyright (c) 2021 Mirjana Stojković, Biljana Nedeljković-Beleslin, Milorad Tesic, Zoran Bukumiric, Jasmina Ciric, Milos Stojanovic Stojanovic, Marija Miletic, Ana Djordjevic-Dikic, Vojislav Giga, Branko Beleslin, Milos Zarkovic

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