Role of Levothyroxine Supplementation in Delayed Recovery Following Cardiac Surgery

Summary

Research indicates that hypothyroidism decreases heart contractility, reduces stroke volume and rate, affects the vascular endothelium, and increases the risk of atherosclerosis, systemic vascular resistance, hypertension, atherogenic lipid profile, and coagulation abnormality . Hypothyroidism was reported to be strongly related to cardiovascular disease, respiratory complications, neurological complications, and a significant difference in ventilator weaning time. Once subclinical hypothyroidism patients are treated with levothyroxine, their physical fitness measured by a 6-minute walk is significantly improved, also showed that levothyroxine treatment can optimize the treatment of heart failure with preserved functions (HFpEF) and heart failure with reduced functions (HFrEF) patients with systolic left ventricular dysfunction and sub clinical hypothyroidism (SCH). The primary aim of this study is to investigate the effect of supplementation of oral levothyroxine in delayed recovery patients post cardiac surgery.

Timeline

Start

2024-11-30

Primary completion

2025-06-15

Completion

2025-06-25

Publications

• Background Duntas LH, Jonklaas J. Levothyroxine Dose Adjustment to Optimise Therapy Throughout a Patient's Lifetime. Adv Ther. 2019 Sep;36(Suppl 2):30-46. doi: 10.1007/s12325-019-01078-2. Epub 2019 Sep 4.
• Background Flores S, Checchia PA. Inflammatory and neurohormonal modulation for congenital heart surgery: The quest continues. J Thorac Cardiovasc Surg. 2018 Sep;156(3):1207-1208. doi: 10.1016/j.jtcvs.2018.06.004. Epub 2018 Jun 22. No abstract available.
• Background Batra YK, Singh B, Chavan S, Chari P, Dhaliwal RS, Ramprabu K. Effects of cardiopulmonary bypass on thyroid function. Ann Card Anaesth. 2000 Jul;3(2):3-6.
• Background Zhang JQ, Yang QY, Xue FS, Zhang W, Yang GZ, Liao X, Meng FM. Preoperative oral thyroid hormones to prevent euthyroid sick syndrome and attenuate myocardial ischemia-reperfusion injury after cardiac surgery with cardiopulmonary bypass in children: A randomized, double-blind, placebo-controlled trial. Medicine (Baltimore). 2018 Sep;97(36):e12100. doi: 10.1097/MD.0000000000012100.
• Background Kumar A, Taliyan R, Sharma PL. Evaluation of thyroid hormone induced pharmacological preconditioning on cardiomyocyte protection against ischemic-reperfusion injury. Indian J Pharmacol. 2012 Jan;44(1):68-72. doi: 10.4103/0253-7613.91870.
• Background Plumpton K, Haas NA. Identifying infants at risk of marked thyroid suppression post-cardiopulmonary bypass. Intensive Care Med. 2005 Apr;31(4):581-7. doi: 10.1007/s00134-004-2549-1. Epub 2005 Jan 28.
• Background Gerdes AM, Ojamaa K. Thyroid Hormone and Cardioprotection. Compr Physiol. 2016 Jun 13;6(3):1199-219. doi: 10.1002/cphy.c150012.
• Background Biondi B, Klein I. Hypothyroidism as a risk factor for cardiovascular disease. Endocrine. 2004 Jun;24(1):1-13. doi: 10.1385/ENDO:24:1:001.

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