Challenges in the Management of Atrial Fibrillation With Subclinical Hyperthyroidism.
Challenges in the Management of Atrial Fibrillation With Subclinical Hyperthyroidism.
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DOI：
10.3389/fendo.2021.795492
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发表时间：
2021
影响因子：
5.2
通讯作者：
Collet TH
中科院分区：
文献类型：
--
作者：
Gencer B;Cappola AR;Rodondi N;Collet TH
亚临床甲状腺疾病在老年人和妇女中有很高的患病率。亚临床甲状腺功能减退症是通过血清促甲状腺激素(TSH)水平升高且甲状腺激素水平在参考范围内来诊断的，亚临床甲状腺功能亢进症是通过TSH水平与甲状腺激素和三碘甲腺原氨酸水平在参考范围内相结合来诊断的。房颤是最常见的心律失常，与死亡率、心力衰竭、中风和抑郁症的风险增加有关。来自动物和人类生理学研究的机制数据以及人类的观察数据支持亚临床甲亢与房颤之间的联系。指南建议在评估新发心房颤动时测量TSH。所有显性甲亢患者均应予以治疗，TSH+0.4MLU/L的65岁以上患者或TSH+0.1MLU/L的年轻患者应考虑亚临床甲亢的治疗。指南还建议对已知的甲亢患者进行房颤筛查。连续测量心脏电活动的可穿戴设备可能是检测高危患者心房颤动的一种新策略。在这篇综述中，我们探讨了甲状腺激素与房颤的相互作用，亚临床甲亢的治疗争议，以及改善亚临床甲亢患者房颤治疗的潜在策略。
Subclinical thyroid disorders have a high prevalence among older individuals and women. Subclinical hypothyroidism is diagnosed by elevated serum levels of thyroid-stimulating hormone (TSH) with thyroxine levels within the reference range, and subclinical hyperthyroidism is diagnosed by low TSH in conjunction with thyroxine and triiodothyronine levels within reference ranges. Atrial fibrillation is the most commonly diagnosed cardiac arrhythmia and has been associated with an increased risk of mortality, heart failure, stroke, and depression. Mechanistic data from animal and human physiology studies as well as observational data in humans support an association of subclinical hyperthyroidism with atrial fibrillation. Guidelines recommend the measurement of TSH in the evaluation of new-onset atrial fibrillation. All patients with overt hyperthyroidism should be treated, and treatment of subclinical hyperthyroidism should be considered in patients older than 65 years with TSH < 0.4 mlU/L, or in younger patients with TSH < 0.1 mlU/L. Guidelines also recommend screening for AF in patients with known hyperthyroidism. Wearable devices that measure the heart electrical activity continuously may be a novel strategy to detect atrial fibrillation in patients at risk. In this review, we explore the interplay between thyroid hormones and atrial fibrillation, management controversies in subclinical hyperthyroidism, and potential strategies to improve the management of atrial fibrillation in patients with subclinical hyperthyroidism.
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影响因子：
37.8
作者：
Baumgartner C;da Costa BR;Collet TH;Feller M;Floriani C;Bauer DC;Cappola AR;Heckbert SR;Ceresini G;Gussekloo J;den Elzen WPJ;Peeters RP;Luben R;Völzke H;Dörr M;Walsh JP;Bremner A;Iacoviello M;Macfarlane P;Heeringa J;Stott DJ;Westendorp RGJ;Khaw KT;Magnani JW;Aujesky D;Rodondi N;Thyroid Studies Collaboration
通讯作者：
Thyroid Studies Collaboration
影响因子：
4.8
作者：
Ashburner, Jeffrey M.;Atlas, Steven J.;Lubitz, Steven A.
通讯作者：
Lubitz, Steven A.
DOI：
10.1016/s0735-1097(01)01731-4
发表时间：
2002-01-16
影响因子：
24
作者：
Chen, YC;Chen, SA;Lin, CI
通讯作者：
Lin, CI
影响因子：
4.7
作者：
Biondi, Bernadette;Bartalena, Luigi;Kahaly, George J.
通讯作者：
Kahaly, George J.
影响因子：
37.8
作者：
Freedman, Ben;Camm, John;Yan, Bryan P.
通讯作者：
Yan, Bryan P.