HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Dyke, C. M. Articles by Salter, D. R. Search for Related Content PubMed PubMed Citation Articles by Dyke, C. M. Articles by Salter, D. R.

Ann Thorac Surg 1991;52:14-19
© 1991 The Society of Thoracic Surgeons

---

Articles

Triiodothyronine-enhanced left ventricular function after ischemic injury

Department of Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia USA

^_* Address reprint requests to Dr Salter, Hunter Holmes McGuire Veterans Medical Center, 1201 Broad Rock Blvd, Richmond, VA 23298.

	Abstract

Top Abstract Footnotes References

 
Hypothyroidism is associated with profound left ventricular dysfunction. Brain-dead organ donors and patients undergoing cardiopulmonary bypass are chemically hypothyroid with significantly reduced circulating free triiodothyronine (T₃). To test the hypothesis that T₃ enhances left ventricular function in a hormonally deficient environment a total of 36 healthy New Zealand White rabbit hearts were studied using a modified Langendorff preparation with Krebs-Henseleit perfusate and intraventricular balloon. In 9 normal rabbit hearts a cumulative dose-response curve with logarithmically increasing doses of T₃ was obtained. The vehicle solution for T₃ dissolution served as control (n = 9). Left ventricular function was assessed from peak developed pressure at baseline and after T₃ administration. Triiodothyronine had no effect in normal hearts on peak developed pressure or end-diastolic pressure. In 18 rabbits, the acute effect of T₃ administration after ischemia was investigated. Preischemic left ventricular function was measured to serve as baseline, and hearts were subjected to 37 °C global ischemia. Triiodothyronine (n = 9) or vehicle (n = 9) was infused during reperfusion, and left ventricular peak developed pressure was measured at 30 and 60 minutes of reperfusion. Recovery of function (expressed as percent return of left ventricular peak developed pressure) was significantly improved within 15 minutes of reperfusion (65.0% ± 2.1% versus 80.2% ± 4.1%) and remained significantly improved throughout the reperfusion period (p < 0.05 by analysis of variance). These data suggest that although T₃ possesses no inotropic properties, it significantly improves postischemic left ventricular function. The rapidity of the functional improvement suggests that these effects may be due to plasma membrane-mediated mechanisms.

	Footnotes

Top Abstract Footnotes References

 
Presented at the Twenty-seventh Annual Meeting of The Society of Thoracic Surgeons, San Francisco, CA, Feb 18–20, 1991.

This study was supported in part by grant HL 26302-11 from the National Institutes of Health and by a Small Grants Award from the Medical College of Virginia.

	References

Top Abstract Footnotes References

 

1. Slag MF, Morley JE, Elson MK, et al. Hypothyroxinemia in critically ill patients as a predictor of high mortality JAMA 1981;245:43-45.[Medline]
2. Wartofsky L, Burman KD. Alterations in thyroid function in patients with systemic illness: the euthyroid sick syndrome Endocrinol Rev 1982;3:164-217.
3. Novitsky D, Wicomb WN, Cooper DKC, et al. Electrocardiographic, haemodynamic and endocrine changes occurring during experimental brain death in the Chacma baboon Heart Transplant 1984;4:63-69.
4. Novitsky D, Cooper DKC, Reichart B. Hemodynamic and metabolic responses to hormonal therapy in brain-dead potential organ donors Transplantation 1987;43:852-854.[Medline]
5. Hall GM, Mashiter K, Lumley J, et al. Hypothalamic-pituitary function in the "brain-dead" patient Lancet 1980;2:1259.[Medline]
6. Bremner WF, Taylor KM, Baird S, et al. Hypothalamo-pituitary-thyroid axis function during cardiopulmonary bypass J Thorac Cardiovasc Surg 1978;75:392-399.[Abstract]
7. Robushi G, Medeci D, Fesani F, et al. Cardiopulmonary bypass: a low T3 syndrome with blunted thyrotropin (TSH) response to thyrotropin-releasing hormone (TRH) Horm Res 1986;23:151-158.[Medline]
8. Novitsky D, Cooper DKC, Swanepoel A. Inotropic effect of triiodothyronine (T3) following myocardial ischemia and cardiopulmonary bypass: initial experience in patients undergoing open-heart surgery Eur J Cardiothorac Surg 1989;3:140-145.[Abstract/Free Full Text]
9. Holland II FW, Brown Jr PS, Weintraub BD, Clark RC. Cardiopulmonary bypass and thyroid function: a "euthyroid sick syndrome" Ann Thorac Surg 1991;52:46-50.[Abstract/Free Full Text]
10. Salati M, Scrofani R, Santoli C. Changes in triiodothyronine during cardiopulmonary bypass: a clinical problem [Letter]? J Thorac Cardiovasc Surg 1990;100:464-465.[Medline]
11. Novitsky D, Cooper DKC, Barton CI, et al. Triiodothyronine as an inotropic agent after open heart surgery J Thorac Cardiovasc Surg 1989;98:972-978.[Abstract]
12. Novitsky D, Human PA, Cooper DKC. Inotropic effect of triiodothyronine following myocardial ischemia and cardiopulmonary bypass: an experimental study in pigs Ann Thorac Surg 1988;45:50-55.[Abstract/Free Full Text]
13. Novitsky D, Human PA, Cooper DKC. Effect of triiodothyronine (T₃) on myocardial high energy phosphates and lactate after ischemia and cardiopulmonary bypass J Thorac Cardiovasc Surg 1988;96:600-607.[Abstract]
14. Novitsky D, Matthews N, Shawley D, et al. Triiodothyronine in the recovery of stunned myocardium in dogs Ann Thorac Surg 1991;51:10-17.[Abstract/Free Full Text]
15. Chopra IJ. Euthyroid sick syndrome: abnormalities in circulation thyroid hormones and thyroid hormone physiology in nonthyroid illness Med Grand Rounds 1982;1:201-212.
16. Hamilton MA, Stevenson LW, Luu M, et al. Altered thyroid hormone metabolism in advanced heart failure J Am Coll Cardiol 1990;16:91-95.[Medline]
17. Hearse DJ, Garlick PB, Humphrey SM. Ischemic contracture of the myocardium: mechanism and prevention Am J Cardiol 1971;39:986-993.
18. Williams HM, Ianuzzo CD. The effects of triiodothyronine on cultured neonatal rat cardiac myocytes J Mol Cell Cardiol 1988;20:689-699.[Medline]
19. Umeda PK, Darling DS, Kennedy JM, et al. Control of myosin heavy chain expression in cardiac hypertrophy Am J Cardiol 1987;59:49A-55A.[Medline]
20. Segal J. Action of the thyroid hormone at the level of the plasma membrane Endocrine Res 1989;15:619-649.[Medline]
21. Ling E, O'Brien PJ, Salerno T, et al. Effects of different thyroid treatments on the biochemical characteristics of rabbit myocardium Can J Cardiol 1988;4:301-306.[Medline]
22. Dillman WH. Biochemical basis of thyroid hormone in the heart Am J Med 1990;88:626-630.[Medline]
23. DeNayer P. Thyroid hormone action at the cellular level Horm Res 1987;26:48-57.[Medline]
24. Rudinger A, Mylotte KM, Davis PJ, et al. Rabbit myocardial membrane Ca⁺⁺-ATPase activity: stimulation in vitro by thyroid hormone Arch Biochem Biophys 1984;229:379-385.[Medline]
25. Segal J. In vivo effect of 3,5,3'-triiodothyronine on calcium uptake in several tissues in the rat: evidence for a physiologic role for calcium as the first messenger for the prompt action of thyroid hormone at the level of the plasma membrane Endocrinology 1990;127:17-24.[Abstract/Free Full Text]
26. Dudley SC, Baumgarten CM. Physiologic concentrations of triiodo-L-thyronine increase bursting of cardiac Na⁺ channels [Abstract] Biophys J 1991;59:98.
27. Sterling K. Direct thyroid hormone activation of mitochondria: the role of adenine nucleotide translocase Endocrinology 1986;119:292-295.[Abstract/Free Full Text]
28. Clark RE. Triiodothyronine: to be or not to be, that is the question [Editorial] Ann Thorac Surg 1991;51:5.[Free Full Text]

This article has been cited by other articles:

				P. Ferdinandy, R. Schulz, and G. F. Baxter Interaction of Cardiovascular Risk Factors with Myocardial Ischemia/Reperfusion Injury, Preconditioning, and Postconditioning Pharmacol. Rev., December 1, 2007; 59(4): 418 - 458. [Abstract] [Full Text] [PDF]

				M. Sirlak, L. Yazicioglu, M. B. Inan, S. Eryilmaz, R. Tasoz, A. Aral, and U. Ozyurda Oral thyroid hormone pretreatment in left ventricular dysfunction Eur J Cardiothorac Surg, October 1, 2004; 26(4): 720 - 725. [Abstract] [Full Text] [PDF]

				G. Iervasi, A. Pingitore, P. Landi, M. Raciti, A. Ripoli, M. Scarlattini, A. L'Abbate, and L. Donato Low-T3 Syndrome: A Strong Prognostic Predictor of Death in Patients With Heart Disease Circulation, February 11, 2003; 107(5): 708 - 713. [Abstract] [Full Text] [PDF]

				R. Salenger, J. S. Gammie, and T. J. Vander Salm Postoperative Care of Cardiac Surgical Patients , January 1, 2003; 2(2003): 439 - 469. [Full Text]

				M. Guden, B. Akpinar, E. Saggbas, I. Sanisoglu, E. Cakali, and O. Bayindir Effects of Intravenous Triiodothyronine during Coronary Artery Bypass Surgery Asian Cardiovascular and Thoracic Annals, September 1, 2002; 10(3): 219 - 222. [Abstract] [Full Text] [PDF]

				A. U. Syed, A. F. El Watidy, N. B. Akhlaque, A. Wahba, R. M. El Oakley, K. Imran, E. A. Al Bukhari, and M. R. Al Fagih Coronary Bypass Surgery in Patients on Thyroxin Replacement Therapy Asian Cardiovascular and Thoracic Annals, June 1, 2002; 10(2): 107 - 110. [Abstract] [Full Text] [PDF]

				S. L. Mullis-Jansson, M. Argenziano, S. Corwin, S. Homma, A. D. Weinberg, M. Williams, E. A. Rose, and C. R. Smith A RANDOMIZED DOUBLE-BLIND STUDY OF THE EFFECT OF TRIIODOTHYRONINE ON CARDIAC FUNCTION AND MORBIDITY AFTER CORONARY BYPASS SURGERY J. Thorac. Cardiovasc. Surg., June 1, 1999; 117(6): 1128 - 1135. [Abstract] [Full Text] [PDF]

				C. M. Dyke Triiodothyronine-Enhanced Left Ventricular Function After Ischemic Injury Ann. Thorac. Surg., October 1, 1998; 66(4): 1450 - 1451. [Full Text] [PDF]

				J. D. Klemperer, I. L. Klein, K. Ojamaa, R. E. Helm, M. Gomez, O. W. Isom, and K. H. Krieger Triiodothyronine Therapy Lowers the Incidence of Atrial Fibrillation After Cardiac Operations Ann. Thorac. Surg., May 1, 1996; 61(5): 1323 - 1327. [Abstract] [Full Text]

				M. G. Katz, A. J. Cohen, H. Schwalb, J. Segal, G. Merin, and A. Schachner Interaction of thyroid hormone and heparin in postischemic myocardial recovery Ann. Thorac. Surg., November 1, 1995; 60(5): 1215 - 1218. [Abstract] [PDF]

				J. D. Walker, F. A. Crawford Jr., R. Mukherjee, and F. G. Spinale THE DIRECT EFFECTS OF 3,5,3'-TRIIODO-L-THYRONINE (T3) ON MYOCYTE CONTRACTILE PROCESSES: Insights into mechanisms of action J. Thorac. Cardiovasc. Surg., November 1, 1995; 110(5): 1369 - 1380. [Abstract] [Full Text]

				J. D. Walker, F. A. Crawford Jr, and F. G. Spinale 3,5,3' triiodo-L-thyronine pretreatment with cardioplegic arrest and chronic left ventricular dysfunction Ann. Thorac. Surg., August 1, 1995; 60(2): 292 - 299. [Abstract] [PDF]

				J. D. Walker, F. A. Crawford, and F. G. Spinale PRETREATMENT WITH 3,5,3' TRIIODO-L-THYRONINE (T3): Effects on myocyte contractile function after hypothermic cardioplegic arrest and rewarming J. Thorac. Cardiovasc. Surg., August 1, 1995; 110(2): 315 - 327. [Abstract] [Full Text]

				J. D. Klemperer, J. Zelano, R. E. Helm, K. Berman, K. Ojamaa, I. Klein, O. W. Isom, and K. Krieger Triiodothyronine improves left ventricular function without oxygen wasting effects after global hypothermic ischemia J. Thorac. Cardiovasc. Surg., March 1, 1995; 109(3): 457 - 465. [Abstract] [Full Text]

				B. Murzi, G. Iervasi, S. Masini, R. Moschetti, V. Vanini, G. Zucchelli, and A. Biagini Thyroid hormones homeostasis in pediatric patients during and after cardiopulmonary bypass Ann. Thorac. Surg., February 1, 1995; 59(2): 481 - 485. [Abstract] [PDF]

				J. D. Walker, F. A. Crawford, S. Kato, and F. G. Spinale The novel effects of 3,5,3'-triiodo-L-thyronine on myocyte contractile function and {beta}-adrenergic responsiveness in dilated cardiomyopathy J. Thorac. Cardiovasc. Surg., October 1, 1994; 108(4): 672 - 679. [Abstract] [Full Text]

				T. H. Jones, S. M. Hunter, A. Price, and G. D. Angelini Should thyroid function be assessed before cardiopulmonary bypass operations? Ann. Thorac. Surg., August 1, 1994; 58(2): 434 - 436. [Abstract] [PDF]

				M. Kadletz, P. G. Mullen, M. Ding, L. G. Wolfe, and A. S. Wechsler Effect of triiodothyronine on postischemic myocardial function in the isolated heart Ann. Thorac. Surg., March 1, 1994; 57(3): 657 - 662. [Abstract] [PDF]

				C. M. Dyke, M. Ding, A. S. Abd-Elfattah, K. Loesser, R. J. Dignan, A. S. Wechsler, and D. R. Salter Effects of triiodothyronine supplementation after myocardial ischemia Ann. Thorac. Surg., August 1, 1993; 56(2): 215 - 222. [Abstract] [PDF]

				F. W. Holland II, P. S. Brown Jr, B. D. Weintraub, and R. E. Clark Cardiopulmonary bypass and thyroid function: A "euthyroid sick syndrome" Ann. Thorac. Surg., July 1, 1991; 52(1): 46 - 50. [Abstract] [PDF]

This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Dyke, C. M. Articles by Salter, D. R. Search for Related Content PubMed PubMed Citation Articles by Dyke, C. M. Articles by Salter, D. R.