Kardiyovasküler Hastalıklar ve Tiroid Hormonları Arasındaki İlişki
Derleme Makale
DOI:
https://doi.org/10.5281/zenodo.13309715Anahtar Kelimeler:
TSH, TSH ve Kardiyovasküler Hastalıklar, Hipotiroidizm ve HipertiroidizmÖzet
Tiroid hormonunun asıl hedefleri arasında kardiyovasküler sistemde yer almak bulunur. Kardiyovasküler sistemle ilişkili olan tromboz hipertiroidizm ile bağlantılı iken; hiperlipidemi ise hipotiroidizm ile bağlantılıdır. Bu hormon miyokardiyal kasılabilirliği direkt olarak etkilemektedir. Triiyodotironin [T3, (3,5,3′-triiyodotironin)] ve tiroksin [T4 (3,5,3′,5′- tetraiyodotironin] hormonları tiroid hormonlarını oluşturmaktadır. Vücuttaki metabolik olaylar ile yakından ilişkilidirler. Karbonhidrat, lipid ve protein metabolizması aracılığı ile bazal enerji kullanımının ayarlanmasında rol oynamaktadır. Kardiyovasküler hastalık açısından bakıldığı zaman, T3 ve T4'ün koroner arterlere yönelik etkileri bulunmaktadır. Vasküler düz kas hücrelerini ve vasküler tonusu modüle ederek sistolik arter basıncını yükseltirler. Tiroid hormonunun yeterli düzeyde olmaması ya da işlevini yerine getirememesinden dolayı metabolizma fonksiyonlarında azalması ile kendini gösteren tiroid fonksiyon bozukluğuna hipotiroidzm denir. Hipotiroidizmde yüksek TSH düzeyleri görülürken T4 düzeyleri ise tam tersi düşüktür. Klinik hipotiroidizm, sistolik hiper tansiyon ve lipid anomalilikleri ile bağlantılıdır. Lipid bozukluğuna sebep olarak, hepatik lipaz ve yağ dokusunda lipoprotein lipaz işlevini kısıtlar. Ancak kolesterol sentezinde de artışa neden olur. Tiroid eksikliğinde miyokardiyal remodeling’ te farklılaşmalar meydana gelir. Yaygın olarak ekstrakardiyak organ fonksiyon bozukluğunun oluşumuna neden olur. Yükselmiş tiroid hormonları ile kendini gösteren klinik tiroid fonksiyon bozukluğuna da hipertiroidizm denir. Düşük düzeydeki TSH’ ye karşın yüksek düzeyde T3 ve/veya T4 bulunur. Subklinik hipertiroidizmi gelişen hastalarda koroner arter hastalığı ve kalp yetmezliği gibi KVH riski daha fazla bulunmaktadır. Tiroid hormonlarının aşırılığı kalp debisini fazlalaştırarak atım hacmini ve kalp ritmini etkilemektedir. Bu derlemede kardiyovasküler olaylar ve tiroid hormonları arasındaki ilişkiye kısaca değineceğiz.
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