Echocardiographic assessment of left ventricular function in thyrotoxicosis and implications for the therapeutics of&amp;nbsp;thyrotoxic cardiac disease

Anakwue, Raphael; Onwubere, Bjc; Ikeh, V. O.; Anisiuba, BC; Ike, SO; Anakwue, Angel-Mary C.

doi:10.2147/tcrm.s68752

Cited by 18 publications

(31 citation statements)

References 60 publications

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“…A higher prevalence of 72% and 100% is found by Tsymbaliuk et al [13] in Ukraine and Diallo et al [7] in Mali respectively. In contrast to clinical finding which are suggestive of right heart involvement [7], electrocardiographic findings are more indicative of left heart involvement [15]. In a comparative prospective study between two Senegalese populations with and without cardiothyreosis, Kane et al [14] reported a significantly higher left ventricular mass in population with thyrotoxic heart disease.…”

Section: Electrocardiographic and Echocardiographic Study Of Cardiothmentioning

confidence: 97%

Cardiothyreosis: Risk Factors and Clinical Profile

Diédhiou¹,

Sow²,

Lèye

et al. 2017

OJIM

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Introduction: The diagnosis of cardiothyreosis is based on the presence of the association of thyrotoxicosis and various cardiovascular disorders such as heart failure, coronary artery disease, rhythm or conduction disorders. Data are limited on this entity in Africa which a frequency of 10% to 33% among hyperthyroidism. We aimed to evaluate these risk factors and describe its diagnostic features in Abass Ndao Hospital Center of Dakar. Patients and Methods: It was a descriptive and analytical cross sectional study conducted from 1 January 2010 to 31 December 2014, including all cases of hyperthyroidism with cardiothyreosis. Epidemiological data, cardiovascular risk factors and characteristics of cardiothyreosis were evaluated. Results: 150 cases of cardiothyreosis were collected with a prevalence of 9.8% among 1517 hyperthyroidism. Mean age was 42.6 ± 9 years and sex ratio 0.33. It was a Graves' disease in 82.2% of cases. Time limit of cardiothyreosis appearance was 27 ± 41 months and cardiothyreosis was inaugural in 46.6%. Electrocardiogram showed an arrhythmia (38.7%), coronary insufficiency (8%). On echocardiography assessment, impairment of left ventricular ejection fraction (LVEF) was found in 18.5%. Of these, it was 34.7% of arrhythmia, 8.6% of coronary insufficiency and 65.2% of heart failure. Among patients with pulmonary artery hypertension (PAH) (57.3%), there were a rhythm disorder (38%), coronary insufficiency (5.6%) and heart failure (78.8%). Female gender was the only one at risk of arrhythmia (p = 0.01) and impaired of left ventricular ejection fraction (p = 0.007). Existence of a free T4 > 50 pmol/L (p = 0.05) were only at risk of developing pulmonary artery hypertension. Conclusion: Cardiothyreosis is a significant complication. These discovery methods call for more early diagnosis and appropriate treatment.

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Section: Electrocardiographic and Echocardiographic Study Of Cardiothmentioning

confidence: 97%

Cardiothyreosis: Risk Factors and Clinical Profile

Diédhiou¹,

Sow²,

Lèye

et al. 2017

OJIM

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“…However, in this study only in 20% of cases was the hypertension systolic suggesting pre-existing diastolic hypertension. The large burden of cardiac disease seen in thyrotoxicosis in Africa has been noted by several authors , Anakwue et al 2015. This was attributed to some genetic susceptibility.…”

Section: Thyrotoxicosis Hypertension and Heart Diseasementioning

confidence: 87%

Thyrotoxicosis, Etiology, Presentation and Management Challenges in Nigeria: A Review of Cases Seen Over a 5 Year Period

Onyenekwe

2019

ESJ

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Background: Thyrotoxicosis is a common endocrine disorder worldwide with a female predominance. Graves disease is reported as the commonest cause of thyrotoxicosis by various authors in the Africa region. Aims and Objectives: The study evaluated patient characteristics, clinical and laboratory profile, co-morbidities, treatment modalities, response to therapy, side effects of anti-thyroid medications, treatment outcome and complications of the disease in patients with thyrotoxicosis. Materials and methods: This study was retrospective and observational. The records of patients diagnosed with overt thyrotoxicosis seen in the Endocrine unit (2013-2017) were pulled and relevant data compiled. Data was analyzed using SPSS V 21. Results: A total of 172 cases were studied; 33 males and 132 females (ratio 1:4). They were aged 18-70; 40.2 ±12.5 years. Graves Disease constituted 79 % 0f cases and toxic multinodular goiter made up 18%. Seven cases of Marine Lenhart syndrome were identified. Graves orbitopathy occurred in 54%, but was mild. All but 6 patients received anti-thyroid medication as initial therapy mainly carbimazole (90%). About 6% had thyroidectomy. Treatment default was high (52%), while 15% remitted and 19% relapsed. Total duration of illness was 1-380, 40.7 ± 52.6 months. Drug rash occurred in 5% and cholestatic hepatitis in 1.8%. Hypertension coexisted in 35%. Six pregnancies were recorded, four of which ended in miscarriages, two of which had thyroid storm. Heart disease complicated the disease in 36%. Conclusion: Thyrotoxicosis is a common clinical condition. Treatment with carbimazole is effective. However the treatment default rate was very high. Coexisting hypertension and pronlonged period of untreated disease exposed patients to a high burden of heart disease. Patient education and introduction of radioablation therapy will mitigate these challenges.

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“…Hyperthyroidism is defined as a clinical condition that resulted from abnormal high serum thyroid hormone levels [ 1 ]. Any increase in the level of thyroid hormone leads to change in many systems of human body including cardiovascular system because thyroid hormone acts through genomic and non-genomic mechanisms to regulate cardiac function [ 2 ]. Cardiomyocytes have thyroid hormone nuclear receptors that when bound alter gene transcription, can regulate intracellular calcium metabolism and myofilaments.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of diastolic function in newly diagnosed hyperthyroid patients with preserved left ventricular systolic function

Shojaeifard

Davoudi

Erfanifar

et al. 2020

Cardiovascular Endocrinology &Amp; Metabolism

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Background Diastolic dysfunction has been reported as a cardiovascular effect of hyperthyroidism, and is also supposed to be a cause of heart failure manifestations in the patients with preserved ejection fraction (EF). Methods For evaluation of diastolic function in hyperthyroid patients and also diastolic function during performing exercise stress echocardiography, we conducted this study on 25 newly diagnosed hyperthyroid patients compared to 26 healthy subjects as control group. Diastolic function of the patients at rest was assessed using these parameters as follows: left atrium volume index, tricuspid regurgitation (TR) velocity, mitral inflow early diastolic flow (E wave), tissue Doppler of mitral annular velocity (e′), E/e′ ratio, and isovolumic relaxation time (IVRT); and during exercise stress echocardiography, we judged diastolic response by measuring E/e′ ratio and TR velocity at the peak of stress. Results The mean age of the patients was 39.64 ± 12.23 years old and 52% of them were female. History of exertional dyspnea was found in 64% of patients. All the patients had normal diastolic function at the time of resting and there was no significant difference in diastolic parameters between the two groups except for IVRT, which was lower in hyperthyroid patients. Interestingly, no patients developed diastolic dysfunction during exercise stress echocardiography. Conclusion Our finding did not show diastolic dysfunction in hyperthyroid patients neither at rest nor during exercise echocardiography and did not support the hypothesis that diastolic dysfunction can be a cause of exertional intolerance and dyspnea in the patients with preserved EF.

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Echocardiographic assessment of left ventricular function in thyrotoxicosis and implications for the therapeutics of thyrotoxic cardiac disease

Cited by 18 publications

References 60 publications

Cardiothyreosis: Risk Factors and Clinical Profile

Cardiothyreosis: Risk Factors and Clinical Profile

Thyrotoxicosis, Etiology, Presentation and Management Challenges in Nigeria: A Review of Cases Seen Over a 5 Year Period

Evaluation of diastolic function in newly diagnosed hyperthyroid patients with preserved left ventricular systolic function

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