{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T08:58:38Z","timestamp":1774342718656,"version":"3.50.1"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"\n Background<\/jats:title>\n The relationship between thyroid hormone sensitivity and atrial fibrillation (AF) progression remains unclear.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to investigate the relationship between impaired thyroid hormone sensitivity and the progression of AF in individuals with normal thyroid function.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This retrospective cross-sectional study included 1,190 consecutive patients with AF, who were classified into paroxysmal AF (\n n<\/jats:italic>\n \u2009=\u2009623) and persistent AF (\n n<\/jats:italic>\n \u2009=\u2009567) groups. Data on cardiac ultrasound and serum biochemical parameters were obtained. Thyroid hormone sensitivity was assessed using a parametric thyroid feedback quantile-based index (PTFQI), thyrotropin-thyroxine resistance index (TT4RI), and peripheral free triiodothyronine\/free thyroxine (FT3\/FT4) ratio. Logistic regression analysis was performed to assess the relationship between thyroid hormone sensitivity indices and AF classification.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Compared with the paroxysmal AF group, patients with persistent AF exhibited significantly higher PTFQI and TT4RI values and a lower FT3\/FT4 ratio (\n P<\/jats:italic>\n for trend &lt;0.001). In the multivariable logistic regression analysis, persistent AF was independently and significantly associated with elevated TT4RI and PTFQI as well as a reduced FT3\/FT4 ratio (all\n P<\/jats:italic>\n for trend &lt;0.05). In the fully adjusted model, the odds ratios (95% confidence intervals) for TT4RI, PTFQI, and FT3\/FT4 ratios were 1.038 (1.010\u20131.066), 4.063 (1.527\u201310.809), and 0 (0\u20130.071), respectively. Quartile-based analysis further revealed a consistent and significant association between higher PTFQI scores and the probability of persistent AF across all upper quartiles (\n P<\/jats:italic>\n \u2009&lt;\u20090.01). The FT3\/FT4 ratio demonstrated a non-linear association with persistent AF, acting as a risk factor in the third quartile (Q3,\n P<\/jats:italic>\n for trend\u2009=\u20090.018) and as a protective factor in the fourth quartile (Q4,\n P<\/jats:italic>\n for trend\u2009=\u20090.003). No statistically significant differences were observed between TT4RI quartiles.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Impaired thyroid hormone sensitivity may contribute to the progression from paroxysmal to persistent AF in euthyroid patients; however, its clinical predictive value requires further validation in large-scale studies.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1674778","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T05:25:42Z","timestamp":1774329942000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impaired sensitivity to thyroid hormones is associated with atrial fibrillation in the euthyroid population"],"prefix":"10.3389","volume":"13","author":[{"given":"Han","family":"Gong","sequence":"first","affiliation":[{"name":"Department of Cardiology, The First Affiliated Hospital of Dalian Medical University","place":["Dalian, 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China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Liu","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Diseases, The First Affiliated Hospital of Dalian Medical University","place":["Dalian, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaomeng","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The First Affiliated Hospital of Dalian Medical University","place":["Dalian, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1161\/cir.0000000000001193","article-title":"2023 ACC\/AHA\/ACCP\/HRS guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology\/American Heart Association joint committee on clinical practice 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