Thyroid hormone and cardiac disease: from basic concepts to clinical application.
Thyroid hormone and cardiac disease: from basic concepts to clinical application.
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DOI：
10.4061/2011/958626
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发表时间：
2011
影响因子：
2.1
通讯作者：
Iervasi G
中科院分区：
文献类型：
--
作者：
Mourouzis I;Forini F;Pantos C;Iervasi G
自然界的再生模型提供了大量证据，表明心脏可能存在自然愈合过程。 受损心肌和发育中的心脏之间存在的相似性强烈表明，驱动胚胎心脏发育的调节因子也可能控制心脏再生的各个方面。在这种情况下，甲状腺激素（TH），这是心脏发育过程中的成熟至关重要的似乎有一个修复作用，在成年生活。因此，TH -甲状腺激素受体（TR）稳态的变化被证明可以控制受损心肌恢复到胎儿表型。因此，甲状腺激素治疗优先通过重新激活发育基因编程来重建受损的心肌。临床数据提供了进一步的支持，这一实验证据和TH水平的变化，特别是减少生物活性的三碘甲状腺原氨酸（T3）在心肌梗死后或心力衰竭的发展过程中，血浆中，与患者的发病率和死亡率密切相关。 TH再生病变心脏的潜力现已在一项II期、随机、双盲、安慰剂对照研究（THiietin研究）中在急性心肌梗死患者中进行了测试。
Nature's models of regeneration provide substantial evidence that a natural healing process may exist in the heart. Analogies existing between the damaged myocardium and the developing heart strongly indicate that regulatory factors which drive embryonic heart development may also control aspects of heart regeneration. In this context, thyroid hormone (TH) which is critical in heart maturation during development appears to have a reparative role in adult life. Thus, changes in TH -thyroid hormone receptor (TR) homeostasis are shown to govern the return of the damaged myocardium to the fetal phenotype. Accordingly, thyroid hormone treatment preferentially rebuilds the injured myocardium by reactivating developmental gene programming. Clinical data provide further support to this experimental evidence and changes in TH levels and in particular a reduction of biologically active triiodothyronine (T3) in plasma after myocardial infarction or during evolution of heart failure, are strongly correlated with patients morbidity and mortality. The potential of TH to regenerate a diseased heart has now been testing in patients with acute myocardial infarction in a phase II, randomized, double blind, placebo-controlled study (the THiRST study).