Mortality rate in Lithuania is among highest in Europe and cardiovascular mortality covers about 56% of the general mortality. Survivors after MI or stroke often demonstrate symptoms of depression, fatigue, poor cognitive functioning worsening health related quality life. Finding modifiable factors and biomarkers that affect both mortality and quality of life after acute cardiovascular events is an important task understanding and improving outcomes in cardiovascular disease. Decrease in triiodothyronine (T3) concentrations is observed in patients after acute MI and stroke have been linked to its adverse prognosis and to co-morbidities such as depression. Genetic alterations in various components of thyroid hormone signalling and environmental factors such as dietary selenium or iodine are associated with morbidity, mortality and well-being of patients. However, these interactions in patients after acute cardiovascular events have not been studied. Better understanding thyroid hormone signalling in brain-thyroid-heart interaction may open new markers and new targets managing MI and stroke as well as depression.
The aim of this research project is to establish whether polymorphism in thyroid axis related genes interacting with environmental factors affect thyroid hormone concentrations, survival and well-being of patients experiencing major cardiovascular events.
To reach these aims we plan to recruit patients after acute MI and patients after stroke and in cross-sectional and in follow-up design to evaluate if clinical, psychological, endocrine, environmental and genetic factors affects survival after major cardiovascular events and health related quality of life in survivors. This complex interdisciplinary study requires concert action of cardiologists, psychiatrists, geneticists, neurologists, environmentalists and endocrinologists. The multidisciplinary group of the experienced researchers covering all fields of interest will be established. Site of the study, Lithuanian University of Health Sciences and its Clinics, the largest medical centre in the country, will provide modern research and clinical facilities and will contribute to the success of the project.
We expect that the project will give important new knowledge in understanding mechanisms by which gene and environmental factors are associated with cardiovascular events, and by which it affects outcomes and well-being of patients. It will also provide pharmacogenetic foundation for new clinical trials evaluating endocrine, cardiovascular and dietary interventions in patients after acute MI or stroke.