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Recombinant Human Thyrotropin Enhances Endothelial-Mediated Vasodilation of Conduit Arteries

Department of Internal Medicine and Cardiovascular Sciences (R.N., V.A., G.B., C.D., A.D.S., C.P., A.M., U.O., M.M., L.S.) and Department of Clinical and Molecular Endocrinology and Oncology (G.A.L., G.C., G.L.), University Federico II, 80131 Naples, Italy

Address all correspondence and requests for reprints to: Raffaele Napoli, M.D., Department of Internal Medicine and Cardiovascular Sciences, Via Pansini 5, 80131 Napoli, Italy. E-mail: napoli{at}unina.it.

Context: Endothelial cells possess receptors to TSH. Their role is largely unknown.

Objectives: The objective of the study was to determine whether elevated serum TSH levels, as occur in hypothyroidism, affect endothelial function of large arteries and vascular risk biomarkers.

Subjects and Methods: Thirty-four consecutively recruited patients, who had undergone thyroidectomy for thyroid carcinoma, were studied in connection with one of the monitoring procedures based on recombinant human (rh) TSH administration. Flow-mediated dilation (FMD) of the brachial artery and serum vascular risk markers were measured at baseline and for 5 d after the administration of rhTSH (0.9 mg im on d 1 and 2). Holter electrocardiogram and echocardiography were performed on d 2.

Results: rhTSH caused a rapid increase in flow-mediated dilation from the basal value of 10.2 to 15.6% at 6 h (P < 0.0000001), to 16.1% on d 2 (P < 0.0000001), and to 14.9% on d 6 (P = 0.0015). The results were identical when the analysis was made in a subgroup of 19 patients free of vascular risk conditions. Vascular cell adhesion molecule-1, TNF, IL-6, and high sensitive C-reactive protein were unaffected by rhTSH, whereas homocysteine was decreased. Arterial blood pressure, mean 24-h heart rate, and left ventricular function were unaffected by rhTSH.

Conclusions: rhTSH causes marked and persistent activation of the endothelial mediated vasodilation, independent of systemic hemodynamic changes.

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