Thyroid Hormone Treatment after Coronary-Artery Bypass Surgery

• Published in: The New England journal of medicine Vol. 333; no. 23; pp. 1522 - 1527
• Main Authors: Klemperer, John D, Klein, Irwin, Gomez, Maureen, Helm, Robert E, Ojamaa, Kaie, Thomas, Stephen J, Isom, O. Wayne, Krieger, Karl
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 07-12-1995
• Subjects: Aged; Biological and medical sciences; Cardiology. Vascular system; Coronary Artery Bypass; Coronary Disease - complications; Coronary Disease - physiopathology; Coronary Disease - surgery; Coronary heart disease; Female; Heart; Heart surgery; Hemodynamics - drug effects; Humans; Male; Medical sciences; Middle Aged; Postoperative Care; Thyroid diseases; Thyroid gland; Treatment Outcome; Triiodothyronine - blood; Triiodothyronine - therapeutic use; Ventricular Dysfunction, Left - complications; Ventricular Dysfunction, Left - drug therapy; Ventricular Function - drug effects; Human; Treatment; Infarct; Bypass; Surgery; Coronary artery; Myocardium; Cardiovascular disease; Thyroid hormone; Coronary heart disease; Myocardial disease
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM199512073332302

Poor cardiac performance is a major cause of morbidity and death in patients who undergo open-heart surgery, especially older patients and those with extensive disease or poor ventricular function.
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Physicians therefore are challenged to improve perioperative management. Because of recent evidence that cardiopulmonary bypass results in altered thyroid hormone metabolism,
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,
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interest has focused on the relation between decreased serum triiodothyronine concentrations and hemodynamic variables after cardiopulmonary bypass.
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There are similarities between hypothyroid patients and those undergoing cardiac surgery with respect to both serum triiodothyronine concentrations and decreased cardiac contractility and elevated peripheral vascular resistance
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,
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; prior studies have . . .