Thyrotoxic Cardiomyopathy and Heart Failure in Patients with Toxic Goiter. Changes after Surgery

Abstract

Changes in the severity of heart failure in patients with toxic goiter after surgery are insufficiently studied.The objective of the research was to study changes in cardiac disorders in the remote period after surgical treatment of toxic goiter.Material and methods. The study included 48 patients with toxic goiter and moderate thyrotoxicosis and 102 patients with severe thyrotoxicosis. Cardiac disorders and changes in cardiac function after surgery were studied using the following gradation: good, satisfactory, unsatisfactory results and ineffective treatment.Results. Good and satisfactory results of surgical treatment in patients with moderate thyrotoxicosis were obtained in 47 (98%) cases and in patients with severe thyrotoxicosis they were achieved in 45 (44%) cases. Unsatisfactory outcome was determined by the severity of thyrotoxicosis, its duration, and low exercise tolerance during the 6-min walking test.Conclusions. Persistent severe thyrotoxicosis leads to atrial fibrillation and heart failure, which in most cases (66%) after surgical treatment of toxic goiter do not undergo reversible changes.

Серцеві Наслідки Тяжкого Тиреотоксикозу Та Їх Зміни У Віддаленому Періоді Після Хірургічного Лікування

“…Після медикаментозного або хірургічного лікування ТТ і досягнення еутиреозу синусовий ритм відновлюється лише в 19 % пацієнтів, які мали ФП [8,9]. Найчастіше ці зміни настають у випадках, коли пацієнт молодий і тривалість гіпертиреозу незначна.…”

Long-term results of surgical treatment in patients with toxic goiter and severe thyrotoxicosis

“…After medical or surgical treatment of TT and the achievement of euthyroidism, sinus rhythm is restored in 19-66% of the patients who had AF 12 . Functional and structural changes of the heart in case of thyrotoxicosis, in particular AF, are the cause of the increase in mortality from embolism in these patients, 1.2-1.4 times compared to the general population [13][14][15][16] .…”