As so often, the full paper is not available to us. However, even the abstract recognises the importance of thyroid hormone in relation to the heart, and the growing understanding of that importance.
Note the use of the phrase "even subtle changes in thyroid hormone concentrations" - and we have to put up with systems that scrap prescriptions totally, or adjust by riduculous amounts - halving or doubling. And leave subclinical entirely untreated.
Yet again, it is looking more likely that any revolution in thyroid treatment will arrive from outwith endocrinology. Whether that is cardiology, psychiatry, dermatology, or wherever else.
Nature Reviews Cardiology | Review
Thyroid hormones and cardiovascular disease
Avais Jabbar, Alessandro Pingitore, Simon H. S. Pearce, Azfar Zaman, Giorgio Iervasi & Salman Razvi
Nature Reviews Cardiology
04 November 2016
Myocardial and vascular endothelial tissues have receptors for thyroid hormones and are sensitive to changes in the concentrations of circulating thyroid hormones. The importance of thyroid hormones in maintaining cardiovascular homeostasis can be deduced from clinical and experimental data showing that even subtle changes in thyroid hormone concentrations — such as those observed in subclinical hypothyroidism or hyperthyroidism, and low triiodothyronine syndrome — adversely influence the cardiovascular system. Some potential mechanisms linking the two conditions are dyslipidaemia, endothelial dysfunction, blood pressure changes, and direct effects of thyroid hormones on the myocardium. Several interventional trials showed that treatment of subclinical thyroid diseases improves cardiovascular risk factors, which implies potential benefits for reducing cardiovascular events. Over the past 2 decades, accumulating evidence supports the association between abnormal thyroid function at the time of an acute myocardial infarction (MI) and subsequent adverse cardiovascular outcomes. Furthermore, experimental studies showed that thyroid hormones can have an important therapeutic role in reducing infarct size and improving myocardial function after acute MI. In this Review, we summarize the literature on thyroid function in cardiovascular diseases, both as a risk factor as well as in the setting of cardiovascular diseases such as heart failure or acute MI, and outline the effect of thyroid hormone replacement therapy for reducing the risk of cardiovascular disease.