Impaired functional and hemodynamic response to graded exercise testing and its recovery in patients with subclinical hyperthyroidism

Vigário, Patrícia dos Santos; Chachamovitz, Dhiãnah Santini de Oliveira; Teixeira, Patrícia de Fátima dos Santos; Santos, Mauro Augusto dos; Oliveira, Fátima Palha de

doi:10.1590/s0004-27302011000300005

Cited by 8 publications

(10 citation statements)

References 36 publications

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“…One study found a significantly higher mean and systolic BP in cancer patients,57 whereas others found no significant difference. No study found a significant difference in diastolic BP between both the groups 49–51,53–59. There were no significant differences in systemic vascular resistance in 2 studies 50,56.…”

Section: Discussionmentioning

confidence: 84%

Long-term treatment-related morbidity in differentiated thyroid cancer: a systematic review of the literature

Parker¹,

Edafe²,

Balasubramanian³

2017

POR

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BackgroundDifferentiated thyroid cancer (DTC) occurs in relatively young patients and is associated with a good prognosis and long survival. The management of this disease involves thyroidectomy, radioiodine therapy, and long-term thyroid-stimulating hormone suppression therapy (THST). The long-term effects of the treatment and the interaction between subclinical hyperthyroidism and long-term hypoparathyroidism are poorly understood. This review sought to examine the available evidence.MethodsA PubMed search was carried out using the search terms “Thyroid Neoplasms” AND (“Thyroxine” OR “Hypocalcemia” OR “Thyrotropin”). Original English language articles published in the last 30 years studying the morbidity from thyroid-stimulating hormone (TSH) suppression and hypoparathyroidism following a surgery for DTC were retrieved and reviewed by 2 authors.ResultsOf the 3,000 results, 66 papers including 4,517 patients were selected for the present study. Studies reported on a range of skeletal (included in 34 studies, 1,647 patients), cardiovascular (17 studies, 957 patients), psychological (10 studies, 663 patients), and other outcomes (10 studies, 1,348 patients). Nine of 26 studies on patients who underwent THST showed a reduction in bone density, and 13 of 23 studies showed an increase in bone turnover markers. Skeletal effects were more marked in postmenopausal women. There was no evidence of increased fracture risk, and only little data were available on hypoparathyroidism. Four of five studies showed an increased left ventricular mass index on echocardiography, and one study showed a higher prevalence of atrial fibrillation (AF). There was little difference in basic physiological parameters and limited literature regarding symptoms or significant events. Six studies showed associations between long-term TSH suppression and impaired quality of life. Impaired glucose metabolism and prothrombotic states were also found in DTC patients.ConclusionThere is limited literature regarding long-term DTC treatment-related morbidity, particularly regarding the effects of long-term hypocalcemia. Most studies have focused on surrogate markers and not on clinical outcomes. A large prospective study on defined clinical outcomes would help characterize the morbidity of treatment and stimulate research on tailoring treatment strategies.

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Section: Discussionmentioning

confidence: 84%

Long-term treatment-related morbidity in differentiated thyroid cancer: a systematic review of the literature

Parker¹,

Edafe²,

Balasubramanian³

2017

POR

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“…Vigário et al 53 evaluated the functional and hemodynamic responses during exercise and recovery in 29 patients with subclinical hyperthyroidism on TSH-suppressive therapy (levothyroxine) for thyroid carcinoma vs. 35 euthyroid subjects. All volunteers underwent cardiopulmonary exercise testing on a treadmill and functional and hemodynamic variables were measured during exercise and recovery.…”

Section: Resultsmentioning

confidence: 99%

[ARTIGO RETRATADO] Exercício e suas interações com vários aspectos da vida do homem e dos animais

Gomes¹,

Rocha-e-Silva²

2012

Acta ortop. bras.

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To review recently published papers in the Brazilian Scientific press on the general subject of physical exercise. All articles published in 2010/2011 found through the keyword exercise were collected from 11 Brazilian Journals. They were hand filtered to exclude all but original research papers. They were grouped according to subject categories and subcategories. A brief summary of all included articles was produced, comparing similar articles between them. The most commonly found interactions refer to exercise vs. the cardiovascular system, metabolism and the locomotor system, in this order. The volume of scientific research in the field is high and of sufficient quality to justify highlighting.

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“…The same skilled professionals conducted all CPET, in a blinded manner with regard to the TSH range (16,(22)(23)(24)26,27).…”

Section: Cardiopulmonary Exercise Testingmentioning

confidence: 99%

“…Concerning to adult population, subclinical hyperthyroidism may be associated with impaired functional and hemodynamic responses during graded cardiopulmonary exercise testing, including: premature achievement of the anaerobic threshold; elevated heart rate (HR); lower peak values of relative oxygen uptake ( O 2 ), relative carbon dioxide production ( CO 2 ) and minute ventilation ( E); chronotropic incompetence; and attenuated HR and blood pressure recovery immediately after exercise (16). Even recently, Mercuro and cols.…”

Section: Introductionmentioning

confidence: 99%

Does low serum TSH within the normal range have negative impact on physical exercise capacity and quality of life of healthy elderly people?

Chachamovitz

Vigário

Carvalho

et al. 2016

Arch. Endocrinol. Metab.

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Objective: Investigate the differences in cardiopulmonary (CP) capacity and Quality of Life (QOL) between healthy elderly (≥ 65 years) with different TSH levels (< 1.0 and ≥ 1.0 μIU/mL) both within the normal range. Also, evaluate the effects of TSH elevation on CP test and QOL, by administering methimazole to subjects with initial lower-normal TSH, in order to elevate it to superior-normal limit. Materials and methods: Initially, a cross-sectional study was performed to compare CP capacity at peak exercise and QOL (using WHOQOL-OLD questionnaire) between healthy seniors (age ≥ 65 years) with TSH < 1.0 μIU/mL vs. TSH ≥1.0 μIU/mL. In the second phase, participants with TSH < 1.0 μIU/mL were included in a non-controlled-prospective-interventional study to investigate the effect of TSH elevation, using methimazole, on QOL and CP capacity at peak exercise. Results: From 89 elderly evaluated, 75 had TSH ≥ 1 μIU/mL and 14 TSH < 1 μIU/mL. The two groups had similar basal clinical characteristics. No difference in WHOQOL-OLD scores was observed between groups and they did not differ in terms of CP function at peak exercise. QOL and CP variables were not correlated with TSH levels. Twelve of 14 participants with TSH < 1.0 μIU/mL entered in the prospective study. After one year, no significant differences in clinical caracteristics, QOL, and CP variables were detected in paired analysis before and after methimazole intervention. Conclusions: We found no differences in CP capacity and QOL between health elderly with different TSH levels within normal range and no impact after one year of methimazole treatment. More prospective-controlled-randomized studies are necessary to confirm or not the possible harm effect in normal low TSH. Arch Endocrinol Metab. 2016;60(3):236-45

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Impaired functional and hemodynamic response to graded exercise testing and its recovery in patients with subclinical hyperthyroidism

Cited by 8 publications

References 36 publications

Long-term treatment-related morbidity in differentiated thyroid cancer: a systematic review of the literature

Long-term treatment-related morbidity in differentiated thyroid cancer: a systematic review of the literature

[ARTIGO RETRATADO] Exercício e suas interações com vários aspectos da vida do homem e dos animais

Does low serum TSH within the normal range have negative impact on physical exercise capacity and quality of life of healthy elderly people?

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