natriuretic-peptide--brain and Hyperthyroidism

Thyroid hormones (THs) significantly affect the cardiovascular system. N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a useful biomarker for diagnosing, evaluating, and predicting outcomes in heart failure (HF). This comprehensive review and meta-analysis aimed to investigate the effects of thyroid dysfunction (hypothyroidism and hyperthyroidism) on NT-proBNP levels.. Two investigators independently searched PubMed, Embase, Cochrane Library, and Web of Science databases for studies published from inception to July 31, 2022, without any restrictions on language.. 21 studies were included. In participants without HF, NT-proBNP levels may be elevated in those with overt hyperthyroidism (standardized mean difference [SMD] 2.38, 95% confidence interval [CI]:1.0-3.76). Notably, among patients with preexisting HF, significantly higher NT-proBNP levels were found in patients with overt hyperthyroidism, overt hypothyroidism, or subclinical hypothyroidism than in euthyroid subjects (SMD [95%CI] = 0.31[0.01, 0.62], 0.32[0.08, 0.56], and 0.33[0.21, 0.46], respectively). Seven trials compared NT-proBNP levels in patients with thyroid dysfunction before and after therapy, and significant drops in NT-proBNP levels were observed in patients with hyperthyroidism (SMD [95%CI] = -1.53[-2.50, -0.55]) upon achieving a euthyroid state. In contrast, increased NT-proBNP levels were observed in hypothyroid patients after treatment (SMD [95%CI] = 1.07[0.28, 1.85]).. Thyroid dysfunction can significantly affect NT-proBNP levels, which may change upon achieving a euthyroid state. Notably, the effect of thyroid dysfunction on cardiac function may depend on the underlying cardiac status. Thus, timely recognition and effective treatment of cardiac symptoms in patients with thyroid dysfunction are mandatory because the prognosis of HF may be improved with appropriate treatment of thyroid dysfunction.. https://www.crd.york.ac.uk/prospero, identifier CRD42022353700.

Topics: Heart Failure; Humans; Hyperthyroidism; Hypothyroidism; Natriuretic Peptide, Brain

Arterial stiffness is thought to play a critical role in the pathogenesis of cardiovascular events, and in hyperthyroidism increased cardiovascular event rates have been reported.. To investigate markers of systemic arterial stiffness, volume homeostasis, and subendocardial perfusion and its interrelationship in patients with Graves' disease (GD) in hyperthyroidism and euthyroidism.. Aortic augmentation index (AIx@75) as a measure of systemic arterial stiffness and subendocardial viability ratio (SEVR) as a surrogate measure of subendocardial perfusion were assessed by applanation tonometry in 59 patients with GD in hyperthyroidism and euthyroidism, and measurements were compared to plasma levels of NT-pro-B-type natriuretic peptide (NT-ProBNP).. AIx@75 and NT-ProBNP levels were significantly increased in hyperthyroidism compared to euthyroidism and were positively correlated with each other. SEVR was significantly decreased in hyperthyroidism compared to euthyroidism, mainly due to increased heart rates as shown by the heart rate-corrected SEVR75.. In hyperthyroidism, patients with GD exhibited increased systemic arterial stiffness, paralleled by increased levels of NT-ProBNP, a marker of volume overload. The decreased subendocardial perfusion in hyperthyroidism seemed to be mainly due to increased heart rates. The observed unfavorable hemodynamic alterations in hyperthyroidism may serve to explain increased cardiovascular event rates in patients with GD.

Topics: Adolescent; Adult; Aged; Arteries; Elasticity; Female; Graves Disease; Humans; Hyperthyroidism; Male; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Thyroxine; Triiodothyronine

Topics: Atrial Natriuretic Factor; Biomarkers; Diagnostic Techniques, Endocrine; Heart Failure; Humans; Hypertension; Hyperthyroidism; Immunoradiometric Assay; Kidney Failure, Chronic; Natriuretic Peptide, Brain; Natriuretic Peptide, C-Type; Reference Values; Specimen Handling; Tachycardia, Supraventricular

We hypothesized that elevated N-terminal-pro-B-type natriuretic peptide levels in hyperthyroidism are mainly driven by increased metabolism due to excess thyroid hormones. Therefore, serum levels of N-terminal-pro-B-type natriuretic peptide were studied during reduced cardiac work load by means of pharmacologically induced heart rate reduction in untreated hyperthyroidism. We designed a noncontrolled interventional study. Eighteen women with newly diagnosed hyperthyroidism were evaluated (including an echocardiography) before and after pharmacological heart rate reduction with 360 mg verapamil daily for 6 days. Before treatment, N-terminal-pro-B-type natriuretic peptide was independently associated with thyroid function (free triiodothyronine-index, r=0.64, p=0.001) and the hemoglobin concentration (r=-0.36, p=0.031). The verapamil treatment induced a decrease in parameters reflecting cardiac function; resting heart rate [from mean 97 to 80 beats per min (17.5%), p<0.001] and mean arterial pressure (8.5%, p=0.001). Median N-terminal-pro-B-type natriuretic peptide increased insignificantly from 224 to 240 pg/ml (p=0.31). Thyrotrotrophin levels were totally suppressed (<0.001 mU/l), free thyroxine-index decreased from median 319 to 315 arbitrary units (p=0.039) and free triiodothyronine-index increased from 8.6 to 9.9 arbitrary units (p=0.010). No changes in echocardiographic parameters were observed. A decrease in resting heart rate in untreated hyperthyroidism due to verapamil treatment did not result in decreasing N-terminal-pro-B-type natriuretic peptide levels. Thus elevated N-terminal-pro-B-type natriuretic peptide in hyperthyroidism seems mainly a result of high metabolism due to excess thyroid hormones rather than increased cardiac work load.

Topics: Adult; Denmark; Female; Heart Rate; Humans; Hyperthyroidism; Middle Aged; Natriuretic Peptide, Brain; Thyroid Function Tests; Verapamil; Young Adult

Serum N-terminal-pro-B-type natriuretic peptide (NT-proBNP) is elevated in systolic heart failure due to volume expansion and pressure overload. Recent data suggest a direct stimulatory effect of thyroid hormones on NT-proBNP synthesis. We examined the influence of acutely induced hyperthyroidism on serum levels of NT-proBNP.. Forty-three healthy women were evaluated before and after treatment with 60 mug triiodothyronine (T(3)) daily for 7 days in a noncontrolled study.. Before treatment, NT-proBNP was independently and inversely associated with thyrotropin (TSH), (r = -0.34, p = 0.02). T(3) therapy induced an increase in free T(3) (3.3 times, p < 0.0001) and suppression of TSH ( p < 0.0001). Heart rate increased by 14% ( p < 0.0001); weight decreased 0.6 kg ( p < 0.0001). Median NT-proBNP increased from 53 to 66 pg/mL ( p < 0.0001). The increase in NT-proBNP levels was independently associated with increase in free T(3) ( p = 0.05) and with reduction in TSH ( p = 0.04), without any association to the changes in cardiac workload.. NT-proBNP is influenced by thyroid function among healthy women, as demonstrated by an inverse association between TSH and NT-proBNP. Induction of an acute hyperthyroid state resulted in an increase in NT-proBNP, which seems to reflect a direct action of T(3) on the NT-proBNP secretion rather than an effect of increased cardiac workload.

Topics: Acute Disease; Aged; Female; Humans; Hyperthyroidism; Middle Aged; Natriuretic Peptide, Brain; Peptides; Regression Analysis; Thyroid Function Tests; Thyrotropin; Time Factors; Treatment Outcome; Triiodothyronine

To investigate the level and clinical significance of plasma B-type natriuretic peptide (BNP) in patients with hyperthyroidism.. Plasma BNP was measured in 32 healthy subjects and 67 patients with clinical hyperthyroidism. Left ventricular anatomy and function was assessed with echocardiography.. The average BNP in hyperthyroid patients was higher than that in healthy subjects (186+/-140 vs 34+/-17 ng/l, p =0.001). The increase in BNP was mainly found in hyperthyroid patients who had clinical and echocardiographic evidence of left ventricular dysfunction (250+/-190 ng/l). The BNP level in patients with hyperthyroidism, but with normal left ventricular function, was similar to that of the controls (37+/-17 vs 34+/-17, ng/l, p>0.05). Multi-regression analysis showed that left atrial diameter and left ventricular ejection fraction were independently associated with the plasma levels of BNP.. there is a significant elevation in plasma BNP in patients with hyperthyroidism; the increase is largely due to hyperthyroidism-induced left ventricular dysfunction. Measurements of plasma BNP may help to detect heart failure in patients with clinical hyperthyroidism.

Topics: Adult; Aged; Biomarkers; Female; Humans; Hyperthyroidism; Male; Middle Aged; Natriuretic Peptide, Brain; Prospective Studies; Thyroid Hormones; Ventricular Function, Left

Natriuretic peptides are produced predominantly in the heart and secreted in response to volume expansion and pressure overload. A wide spectrum of cardiac changes is observed in thyroid dysfunctions. This study investigates mid regional pro A-type (proANP) and N-terminal pro-B-type natriuretic peptide (NTproBNP) levels in different thyroid states and evaluates the effect of L-thyroxine treatment on natriuretic peptides in patients with subclinical hypothyroidism.. Case-control and double-blind, placebo-controlled trial. Sera from 161 female patients (35 with overt, 63 with subclinical hypothyroidism; 10 with overt, 14 with subclinical hyperthyroidism; 40 euthyroid controls) were analysed. ProANP and NT-proBNP were measured at baseline and 48 weeks after L-thyroxine treatment in subclinical hypothyroidism.. Circulating proANP and NT-proBNP levels were higher in hyperthyroid patients than in hypothyroid and euthyroid patients (p <0.001). Plasma proANP levels tended to be lower in overt hypothyroidism than in subclinical hypothyroidism. ProANP and NT-proBNP levels correlated weakly to thyroid stimulating hormone (TSH) (r = -0.3 and -0.2, respectively). The natriuretic peptide levels of subclinical and overt hypothyroid subjects showed no difference with those of euthyroid subjects. L-thyroxine treatment had no effect on natriuretic peptide levels in subclinical hypothyroidism.. Natriuretic peptide levels are altered in different thyroid states with a more pronounced effect in hyperthyroidism than in hypothyroidism. Hyperthyroidism should be considered in patients presenting with unclear symptoms and mildly elevated natriuretic peptide levels, as overt hyperthyroidism results in increased serum A- and B-type natriurectic peptide levels, typically seen in mild heart failure.

Topics: Atrial Natriuretic Factor; Case-Control Studies; Double-Blind Method; Female; Humans; Hyperthyroidism; Hypothyroidism; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Thyroid Function Tests

Although prior studies indicate a high prevalence of atrial fibrillation (AF) in patients with pulmonary embolism (PE), the exact prevalence and prognostic impact are unknown.. We aimed to investigate the prevalence, risk factors and prognostic impact of AF on risk stratification, in-hospital adverse outcomes and mortality in 528 consecutive PE patients enrolled in a single-centre registry between 09/2008 and 09/2017.. Overall, 52 patients (9.8%) had known AF and 57 (10.8%) presented with AF on admission; of those, 34 (59.6%) were newly diagnosed with AF. Compared to patients with no AF, overt hyperthyroidism was associated with newly diagnosed AF (OR 7.89 [2.99-20.86]), whilst cardiovascular risk comorbidities were more frequently observed in patients with known AF. Patients with AF on admission had more comorbidities, presented more frequently with tachycardia and elevated cardiac biomarkers and were hence stratified to higher risk classes. However, AF on admission had no impact on in-hospital adverse outcome (8.3%) and in-hospital mortality (4.5%). In multivariate logistic regression analyses corrected for AF on admission, NT-proBNP and troponin elevation as well as higher risk classes in risk assessment models remained independent predictors of an in-hospital adverse outcome.. Atrial fibrillation is a frequent finding in PE, affecting more than 10% of patients. However, AF was not associated with a higher risk of in-hospital adverse outcomes and did not affect the prognostic performance of risk assessment strategies. Thus, our data support the use of risk stratification tools for patients with acute PE irrespective of the heart rhythm on admission.

Topics: Aged; Aged, 80 and over; Atrial Fibrillation; Biomarkers; Cohort Studies; Comorbidity; Female; Germany; Hospital Mortality; Humans; Hyperthyroidism; Length of Stay; Male; Middle Aged; Multivariate Analysis; Natriuretic Peptide, Brain; Peptide Fragments; Prognosis; Pulmonary Embolism; Registries; Risk Assessment; Troponin

A 35-year-old Japanese man was emergently admitted to our hospital with chief complaints of palpitation and dyspnea. He has been treated for Basedow's disease. He was diagnosed with acute decompensated heart failure, atrial fibrillation and thyrotoxicosis. We started anti-thyroid agents and a treatment for heart failure with beta blockers and diuretics under anti-coagulation therapy. His B-type natriuretic peptide levels remained high, although the heart failure had been compensated and the heart rate was well controlled while hyperthyroidism still existed. We should bear in mind that a discrepancy can exist between the clinical course and the B-type natriuretic peptide level in heart failure patients complicated with hyperthyroidism.

Topics: Adrenergic beta-Antagonists; Adult; Anticoagulants; Atrial Fibrillation; Diuretics; Heart Failure; Humans; Hyperthyroidism; Male; Natriuretic Peptide, Brain; Thyrotoxicosis

To assess the influence of thyroid function on natriuretic peptide concentration in hyperthyroid cats before and after treatment.. Serum natriuretic peptide concentration was measured in 61 hyperthyroid cats recruited from first-opinion clinics before and after treatment.. Following successful treatment, total thyroxine, heart rate, systolic blood pressure and packed cell volume all decreased and bodyweight and creatinine concentrations increased. Furthermore, a significant (P < 0·001) decline in NT-proBNP concentration but not NT-proANP was identified.. Thyroid function has a modest but significant effect on NT-proBNP concentration. Thyroid status should be taken into account when interpreting NT-proBNP concentrations in cats.

Topics: Animals; Antithyroid Agents; Biomarkers; Blood Pressure; Case-Control Studies; Cat Diseases; Cats; Female; Heart Rate; Hyperthyroidism; Male; Methimazole; Natriuretic Peptide, Brain; Natriuretic Peptides; Peptide Fragments; Thyroxine; Treatment Outcome

Several studies have assessed natriuretic peptides in patients with thyroid disorders, and these studies have provided contrasting results. This difference may be partially explained by the presence of concomitant disorders of the cardiovascular system in participants.. The study included 101 patients free of any cardiovascular disorder, who, on the basis of plasma levels of TSH and thyroid hormones, were divided into patients with overt hyperthyroidism, patients with subclinical hyperthyroidism, patients with overt hypothyroidism, patients with subclinical hypothyroidism, and control subjects with normal thyroid profile. Hyperthyroidism was induced either by nodular thyroid disease or by Graves' disease, while hypothyroidism was secondary to autoimmune thyroiditis or surgery.. Compared to control subjects, hyperthyroid patients were characterised by higher plasma levels of NT-pro-BNP. This increase was particularly pronounced in cases of overt disease. On the other hand, neither clinical nor subclinical hypothyroidism was associated with any significant changes in this peptide. Plasma levels of NT-pro-BNP did not differ between patients with Graves' disease and toxic nodular goitre nor between patients with autoimmune hypothyroidism and hypothyroidism secondary to thyroidectomy. Only L-thyroxine substitutions, but not hyperthyroidism treatment, caused changes in plasma concentration of NT-pro-BNP.. Hyperthyroidism and hypothyroidism induce changes of the plasma concentration of NT-pro-BNP. Although both exogenous L-thyroxine and antithyroid drugs restored thyroid function, only the former drug changed plasma NT-pro-BNP content. The thyrometabolic state of a patient should always be taken into consideration when NT-pro-BNP is assessed as a marker of cardiac dysfunction.

Topics: Adult; Aged; Biomarkers; Case-Control Studies; Female; Humans; Hyperthyroidism; Hypothyroidism; Male; Middle Aged; Natriuretic Peptide, Brain; Thyroxine

To evaluate the value of serum brain natriuretic peptide (BNP) in the diagnosis of hyperthyroid heart disease in children.. Fifty-eight children with hyperthyroidism were assigned to two groups according to their cardiac functions: hyperthyroid heart disease (n=28) and hyperthyroidism alone (n=30). Thirty healthy children served as the control group. Serum BNP level, left ventricular ejection fraction (LVEE) and E/A ratio were measured before and after treatment. The diagnostic value of BNP was evaluated in children with hyperthyroid heart disease.. The serum BNP level in the hyperthyroid heart disease and the hyperthyroidism alone groups before treatment was significantly higher than that in the control group (P<0.05), while the LVEF and the E/A ratio were significantly lower than those in the control group (P<0.05). Serum BNP level was positively correlated with the TT3 (r=0.801, P<0.05) and TT4 levels (r=0.578, P<0.05) and negatively with the LVEF (r=-0.48, P<0.05) and the E/A ratio (r=-0.35, P<0.05) in the hyperthyroid heart disease group. The serum BNP, TT3 and TT4 levels in the hyperthyroid heart disease and the hyperthyroidism alone groups were reduced and the LVEF and the E/A ratio increased significantly three months after treatment (P<0.05). When serum BNP level of >323.62 pg/mL was proposed as a cutoff point, the sensitivity, specificity, positive predictive value and negative predictive value were 92.86%, 90.00%, 89.66% and 93.10% respectively for the diagnosis of hyperthyroid heart disease.. BNP may serve as a reliable marker for the diagnosis of hyperthyroid heart disease in children. Serum BNP level along with the LVEF and the E/A ratio may be useful in the evaluation of the severity and the cardiac function in children with this disease.

Topics: Child; Child, Preschool; Female; Heart Diseases; Humans; Hyperthyroidism; Male; Natriuretic Peptide, Brain; Thyroid Hormones; Ventricular Function, Left

BNP are produced in ventricular cardiomyocytes, and secreted in response to volume expansion or pressure overload. The purpose of this study was to assess BNP levels in patients with hyperthyroidism before specific treatment for hyperthyroidism and after euthyroidism was achieved. The study was performed in a prospective design. The study population consisted of 48 consecutive newly diagnosed untreated overt hyper-thyroid patients who had not been treated any anti-thyroid medications before. All subjects underwent transt-horacic echocardiography. Levels of fT3, fT4, TSH and BNP were measured before the onset of the treatment and after euthyroidism was achieved. A significant decrease in BNP (102.5 (6.7-1769) ng/L vs. 5.0 (0.1-87.0) ng/L p< 0.001) levels were observed, after euthyroidism was achieved. The decrease in BNP levels was posi-tively correlated with the decrease in fT3 (r=0.298; p=0.049) and fT4 (r=0.313; p=0.030). There was no cor-relation between BNP levels and TSH levels (p=NS). We conclude that hyperthyroidism may cause high BNP measurements which can lead to misdiagnosis of congestive heart failure. We suggest that thyroid hormones should be checked in patients with high levels of BNP.

Topics: Adult; Diagnostic Errors; Echocardiography, Doppler; Female; Heart Failure; Hemodynamics; Humans; Hyperthyroidism; Male; Middle Aged; Natriuretic Peptide, Brain; Thyrotropin; Thyroxine; Treatment Outcome; Triiodothyronine

Brain natriuretic peptide (BNP) is secreted from the ventricular myocardium in response to volume expansion and pressure overload. Serum BNP levels are also affected by thyroid function status, which was mostly related to a direct stimulatory effect of thyroid hormones on the secretion of BNP. Although the diagnostic value of BNP in heart failure is undisputed, its value in the presence of the thyroid dysfunction has been recently questioned. The aim of this study was to evaluate the influence of thyroid dysfunction on BNP levels.. Evaluation of 18 overt and 47 subclinical hyperthyroid patients together with 39 subclinical and 13 overt hypothyroid patients was carried out in a cross-sectional study. Thirty-three age-, sex- and body mass index (BMI)-matched control subjects were also included.. BNP levels were more than five times higher in hyperthyroid than euthyroid control subjects (P < 0.001). BNP levels were also higher in subclinical hyperthyroidism than euthyroid control subjects (P = 0.09). Correlation analysis revealed that free T4 and free T3 concentrations were associated with high serum BNP levels. The BNP level in patients with subclinical or overt hypothyroidism was similar to that of the controls.. The current study provides additional insight into the diagnostic value of BNP in the presence of coexistent thyroid dysfunction and demonstrates important independent effects of thyroid hormones upon BNP plasma concentrations.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Biomarkers; Cross-Sectional Studies; Female; Heart Failure; Heart Ventricles; Humans; Hyperthyroidism; Hypothyroidism; Male; Middle Aged; Myocardium; Natriuretic Peptide, Brain; Prospective Studies; Thyroid Hormones

It is known that NT-proBNP levels increase in cardiac failure. However, NT-proBNP levels in different thyroid states are still unclear. We aimed to evaluate serum NT-proBNP levels in both hyperthyroid and hypothyroid patients without cardiac insufficiency.. Thirty-six patients with hyperthyroidism (42.9 +/- 16.7 years), 25 patients with hypothyroidism (35.4 +/- 13.9 years) and 34 age-matched euthyroid subjects (41.4 +/- 13.8 years) were included in the study. After anthropometric evaluations, body fat analyses were determined by bioelectrical impedance. Electrocardiography and echocardiography were used in cardiac evaluations. Serum NT-proBNP was measured by immunoassay.. Mean serum NT-proBNP levels in hyperthyroid patients were higher than in both control subjects (13.65 +/- 13.02 vs. 6.50 +/- 4.83 pmol/l, P = 0.002) and hypothyroid patients (13.65 +/- 13.02 vs. 5.98 +/- 5.08 pmol/l, P = 0.003). However, mean serum NT-proBNP levels in hypothyroid patients were not different from those in control subjects. There was a positive correlation between serum NT-proBNP and thyroid hormones (NT-proBNP and FT3: r = 0.324, P = 0.001; NT-proBNP and FT4: r = 0.269, P = 0.009, respectively). Serum NT-proBNP levels were positively correlated with left ventricle end-diastolic diameters (r = 0.232, P = 0.04), interventricular septum thickness (r = 0.315, P = 0.006), and negatively correlated with left ventricular ejection fraction (r = -0.238, P = 0.04).. Serum NT-proBNP levels may increase in hyperthyroidism independently of cardiac insufficiency. Therefore, hyperthyroidism may lead to cardiac ultrastructural changes undetermined by conventional echocardiography and these changes may be responsible for elevation of NT-proBNP levels. In contrast to decreased thyroid hormones, excess thyroid hormones may have a more pronounced effect on serum NT-proBNP levels.

Topics: Adult; Analysis of Variance; Biomarkers; Blood Pressure; Body Mass Index; Case-Control Studies; Echocardiography; Female; Heart Rate; Humans; Hyperthyroidism; Hypothyroidism; Male; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Thyroid Function Tests; Thyroid Gland; Thyroid Hormones

E Natriuretic peptides represent a novel diagnostic tool in the assessment of heart failure. N-terminal-pro-B-type natriuretic peptide (NT-proBNP), a member of the natriuretic peptid family, is produced and released from cardiac ventricles. Changes in cardiac functions are observed in thyroid dysfunctions. The aim of this study was to assess the changes in serum NT-proBNP levels and to evaluate impact of thyroid hormones on serum NT-proBNP in patients with hyperthyroidism and hypothyroidism. Serum NT-proBNP levels were measured in 21 patients with hyperthyroidism and in 24 patients with hypothyroidism and compared with 20 healthy control subjects. Patients without cardiac disease were included into the study as well. Serum NT-proBNP levels were measured by electrochemiluminescence immunoassay. Serum NT-proBNP levels were higher in hyperthyroid patients than in hypothyroid patients and in control subjects, with mean values of 239.03 +/- 47.33, 45.97 +/- 13.48, 55.57 +/- 13.01 pg/ml, respectively (p < 0.0001). Serum NT-proBNP and thyroid hormones were correlated in all patients. Moreover, there was a significant positive correlation between serum NT-proBNP and serum free T4 (FT4) levels (r = 0.549, p = 0.012) in hyperthyroidic patients. Multiple regression analyses demonstrated that increasing FT4 was independently associated with a high serum NT-proBNP levels, whereas heart rate was not in hyperthyroid patients. Serum NT-proBNP levels are higher in the hyperthyroid state as compared with the hypothyroid and euthyroid state. Thyroid dysfunction affects serum NT-proBNP levels, possibly influencing the secretion of the peptide. Therefore, thyroid function has to be considered when evaluating high serum NT-proBNP levels in patients without cardiac dysfunction.

Topics: Adult; Aged; Case-Control Studies; Female; Heart Rate; Humans; Hyperthyroidism; Hypothyroidism; Male; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Thyroid Hormones; Thyrotropin

B-type natriuretic peptides and N-terminal pro-B-type natriuretic peptides (NT-proBNP) have been suggested as being useful for the diagnosis of congestive heart failure. We have shown previously that changes in thyroid function are associated with changes in concentrations of other low molecular weight molecules. Therefore, the aim of this study was to assess whether similar changes occurred with NT-proBNP concentrations following treatment of thyroid dysfunction.. Seventeen patients (12 female, 5 male, age range 24-77 years) with newly diagnosed hypothyroidism and 21 patients (16 female, 5 male, age range 21-66 years) with newly diagnosed hyperthyroidism had NT-proBNP measured at baseline and when they subsequently became euthyroid.. NT-proBNP levels were not significantly different in the hyperthyroid group from the hypothyroid, either before (P = 0.706) or after treatment to euthyroidism (P = 0.170). The hypothyroid group showed a rise in NT-proBNP after treatment (P < 0.001). There was a marginally significant fall in the NT-proBNP levels in the hyperthyroid group (P = 0.05). However, these changes were within the expected wide range of biological variability of NT-proBNP shown in earlier studies.. Hypothyroidism alters NT-proBNP concentrations, but the magnitude of this effect may be lost in the wide biological variability of natriuretic peptides and this statistically significant finding is not likely to be of clinical relevance.

Topics: Adult; Aged; Antithyroid Agents; Carbimazole; Female; Humans; Hyperthyroidism; Hypothyroidism; Immunoassay; Male; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Thyroxine

N-terminal B-type natriuretic peptide (NT-pro-BNP) is secreted from the cardiac ventricles in response to volume expansion and pressure overload, and serum levels are elevated in systolic heart failure. The aim of this study was to evaluate the influence of thyroid function on NT-pro-BNP.. Patients with overt or subclinical thyroid disease were evaluated before and after treatment for their dysthyroid state.. Seventeen overt and 21 subclinical hypothyroid patients together with six subclinical and 13 overt hyperthyroid patients without cardiac disease were included. Subclinical states had, by definition, free T4 and free T3 estimates within reference ranges.. Serum levels of NT-pro-BNP and thyroid hormones were measured, and in 31 patients resting cardiac output was measured by impedance cardiography in the untreated state.. NT-pro-BNP levels were more than four times higher in hyperthyroid than hypothyroid patients, with mean values of 30 and 7 pmol/l, respectively (P < 0.001). Serum NT-pro-BNP levels correlated to the thyroid function (vs. free T4 estimate: r = 0.52, P < 0.0001, n = 57). Treatment resulted in significant increases in NT-pro-BNP in both hypothyroid groups, and decreases in both hyperthyroid groups. A multiple linear regression analysis demonstrated that free T4 and free T3 (P < 0.001) estimates were independently associated with a high serum NT-pro-BNP, whereas cardiac output and resting pulse rate were not.. Serum NT-pro-BNP levels are affected by thyroid function. This seems due to a direct stimulatory effect of thyroid hormones.

Topics: Adult; Aged; Aged, 80 and over; Analysis of Variance; Antithyroid Agents; Cardiac Output; Female; Humans; Hyperthyroidism; Hypothyroidism; Male; Middle Aged; Natriuretic Peptide, Brain; Nerve Tissue Proteins; Peptide Fragments; Regression Analysis; Thyroid Diseases; Thyrotropin; Thyroxine; Triiodothyronine