Thyroid stimulating hormone suppression time on cardiac function of patients with differentiated thyroid carcinoma

Abstract

BackgroundThis study was to investigate the influence of thyroid stimulating hormone (TSH) suppression time on the cardiac function of differentiated thyroid carcinoma (DTC) patients.Methods105 DTC patients were divided into strict TSH suppression group (model group, TSH ≤ 0.1 mU/L) and general TSH suppression group (control group, TSH > 0.1 mU/L). According to the suppression time, these two groups were respectively divided into three groups: group within half a year, group between half a year and a year and group more than a year. Gated myocardial perfusion imaging was applied to observe differences of left ventricle (LV) myocardial perfusion, LV diastolic and systolic function and LV systolic synchrony in every group.ResultsThe left ventricular diastolic function, systolic synchrony and myocardial perfusion level of model group decreased with prolonged suppression time. The values of left ventricular EF, PFR and BPM in patients less than half a year were higher than those in 6 months to 1 year for control group.ConclusionThyroid stimulating hormone suppression can influence the cardiac function of patients and with the prolongation of suppression time, regardless of the level of TSH suppression, the possibility of cardiac function depression in patients will increase. TSH may lower the risk of cardiovascular disease in high-risk patients than those in TSH patients with moderate or low risk. The drugs improving cardiac function should be used cooperatively in different suppression period to decrease the occurrence rate of cardiac adverse reactions.

Progressive diastolic dysfunction in survivors of pediatric differentiated thyroid carcinoma

“…In survivors of 'adult' DTC, the prolonged subclinical hyperthyroidism -induced by TSH suppression therapyis associated with disturbed myocardial relaxation, which can eventually result in diastolic dysfunction (4,16) and increased risk of cardiovascular disease and mortality (17,18,19,20). Strikingly, in our study, TSH levels were not associated with diastolic function.…”

The role of cardiovascular assessment in low risk thyroid neoplasm patients: results from a tertiary care center experience

“…[18][19][20][21] With specific regard to patients treated for thyroid neoplasms, Wang et al analysed clinical and echocardiographic parameters in 105 patients treated for DTC and classified according to TSH-suppression and the duration of such condition: in that study they proved significantly different LVEF, time to peak filling from end-systole and heart rate depending on both those elements. 22 In addition, an increased left ventricular mass was proved in TSH-suppressed DTC patients. 23 Also in the literature review performed by Parker et al an increased mortality, significant differences in terms of IVSd and an increased ventricular mass were described.…”

Cardiovascular Outcomes of Differentiated Thyroid Cancer Patients on Long Term TSH Suppression: A Systematic Review and Meta-Analysis

“…Investigation of clinical parameters may better elucidate this association. It has been shown that left ventricular ejection fraction decreases with TSH suppression lasting over 12 months [35]. Regarding other outcomes, Park et al showed an increase in hypertension and arterial disease in TSH suppressed patients [25], attributing this to the myocardial and vascular function impairment associated with long term suppression [14].…”