Schilddrüsenhormon und kardiovaskuläres System

Zusammenfassung

Schilddrüsenhormone beeinflussen das kardiovaskuläre System in vielfältiger Weise. Viele der klinischen Manifestationen der Hyperthyreose sind durch hämodynamische Veränderungen zu erklären. Die Hypothyreose zeigt umgekehrte Wirkungen auf das kardiovaskuläre System, wenn diese auch klinisch weniger auffällig sind. In einer Übersicht werden sowohl Über- als auch Unterfunktion der Schilddrüse mit ihren Auswirkungen auf das kardiovaskulären Systems dargestellt. Insbesondere wird auf die subklinischen oder latenten Dysfunktionen der Schilddrüse, die vor allem im mittleren und höheren Alter vorkommen, eingegangen. Bisher ist noch nicht eindeutig geklärt, welche klinische Relevanz und welche Notwendigkeit für eine weiterführende Diagnostik und Therapie der subklinischen Schilddrüsenfunktionsstörungen besteht. In den USA wurden im Jahr 2004 von einem Expertengremium Richtlinien festgelegt, die ebenfalls dargestellt werden.

Summary

Thyroid hormone has many effects on the heart and vascular system. In hyperthyroidism changes in cardiovascular hemodynamics explain many of the clinical manifestations induced by thyroid hormones. In hypothyroidism the cardiovascular effects are opposite to those observed in hyperthyroidism, although the clinical manifestations are less obvious. This review will focus on the cardiovascular system in hyperthyroidism and hypothyroidism. In particular the subclinical dysfunctions of the thyroid gland, which occurs especially in older age, will be discussed. The clinical relevance and the necessity of diagnostic and therapy in subclinical thyroid disease are not clarified yet. In the United States an expert group has published a scientific review and guideline for the diagnosis and management of subclinical thyroid disease in 2004, which will also be outlined.

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