Cardiothyreosis: Prevalence and risk factors

Yazidi, Mériem; Chihaoui, Mélika; Oueslati, Hiba; Chaker, Fatma; Rjeb, Ons; Rjaibi, Salsabil; Ouali, Sana; Slimane, Hédia

doi:10.1016/j.ando.2017.11.004

Cited by 4 publications

(9 citation statements)

References 26 publications

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“…Input variables The analysis of previously examined TAF risk factors [4,5,[7][8][9][10][11][12][13][14][15][16][17][18][19] and non-thyrotoxic AF prediction tools [24,[27][28][29][30] helped to define input variables for our models. First, we built several intermediate models, including more than 30 variables.…”

Section: Derivation Of a Thyrotoxic Atrial Fibrillation Prediction Modelmentioning

confidence: 99%

“…Secondly, there were many missing values for the variable other rhythm disorders during hyperthyroidism by contrast to age, for which there was none. Finally, age is an acknowledged TAF risk factor [4,5,[7][8][9][10][11][12][13][14]. Thus, the top five TAF predictors, elicited from our model, include age, hyperthyroidism duration, PAC, PVC and heart rate during hyperthyroidism.…”

Section: Top Thyrotoxic Atrial Fibrillation Risk Factors Elicited From the Prediction Modelmentioning

confidence: 99%

“…To date, a fairly large number of TAF predictors have been identified. Advanced age [4,5,[7][8][9][10][11][12][13][14], concomitant cardiovascular diseases [4,5,7,15] and male gender [4,5,8,14] are the most widely acknowledged. Prolonged duration of hyperthyroidism [14] and increased heart rate [12,14] are the less investigated TAF predictors.…”

Section: Introductionmentioning

confidence: 99%

“…The findings regarding thyroid hormones level have been controversial. Generally, when investigating overt hyperthyroidism, an association of free triiodothyronine (fT3) or free thyroxine (fT4) level with TAF frequency [ 4 , 13 , 14 , 19 ], has not been revealed. By contrast, some researchers have demonstrated that fT3 and fT4, [ 9 ] or fT4 exclusively [ 18 ], have been higher among patients with TAF.…”

Section: Introductionmentioning

confidence: 99%

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Prediction model for thyrotoxic atrial fibrillation: a retrospective study

et al. 2021

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Background Thyrotoxic atrial fibrillation (TAF) is a recognized significant complication of hyperthyroidism. Early identification of the individuals predisposed to TAF would improve thyrotoxic patients’ management. However, to our knowledge, an instrument that establishes an individual risk of the condition is unavailable. Therefore, the aim of this study is to build a TAF prediction model and rank TAF predictors in order of importance using machine learning techniques. Methods In this retrospective study, we have investigated 36 demographic and clinical features for 420 patients with overt hyperthyroidism, 30% of which had TAF. At first, the association of these features with TAF was evaluated by classical statistical methods. Then, we developed several TAF prediction models with eight different machine learning classifiers and compared them by performance metrics. The models included ten features that were selected based on their clinical effectuality and importance for model output. Finally, we ranked TAF predictors, elicited from the optimal final model, by the machine learning tehniques. Results The best performance metrics prediction model was built with the extreme gradient boosting classifier. It had the reasonable accuracy of 84% and AUROC of 0.89 on the test set. The model confirmed such well-known TAF risk factors as age, sex, hyperthyroidism duration, heart rate and some concomitant cardiovascular diseases (arterial hypertension and conjestive heart rate). We also identified premature atrial contraction and premature ventricular contraction as new TAF predictors. The top five TAF predictors, elicited from the model, included (in order of importance) PAC, PVC, hyperthyroidism duration, heart rate during hyperthyroidism and age. Conclusions We developed a machine learning model for TAF prediction. It seems to be the first available analytical tool for TAF risk assessment. In addition, we defined five most important TAF predictors, including premature atrial contraction and premature ventricular contraction as the new ones. These results have contributed to TAF prediction investigation and may serve as a basis for further research focused on TAF prediction improvement and facilitation of thyrotoxic patients’ management.

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Section: Derivation Of a Thyrotoxic Atrial Fibrillation Prediction Modelmentioning

confidence: 99%

Section: Top Thyrotoxic Atrial Fibrillation Risk Factors Elicited From the Prediction Modelmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prediction model for thyrotoxic atrial fibrillation: a retrospective study

et al. 2021

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“…It affects 6.5% of patients with hyperthyroidism. 3 Cardiothyreosis is not well defined since there are no diagnostic criteria for the type of cardiac complication . It can include rhythmic disorders, congestive heart failure and coronary insufficiency.…”

Section: Introductionmentioning

confidence: 99%

Cardiothyreosis: Epidemiological, clinical and therapeutic approach

Elleuch

Molka

Sawssan

et al. 2023

Clin Med Insights Cardiol

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Introduction: Cardiothyreosis corresponds to the cellular effects of free thyroid hormones on the vascular wall and the myocardium. We aim to describe the clinical, para-clinical and therapeutic aspects of cardiothyreosis and to detail prognostic factors. Methods: We conducted a descriptive retrospective study at the Endocrinology-Diabetology Department of the Hedi Chaker University Hospital in Sfax-Tunisia. We collected medical records of 100 patients with cardiothyreosis between January 1999 and December 2019. We included patients with cardiothyreosis who underwent adequate cardiac evaluation. We excluded patients with cardiac abnormalities related to conditions other than hyperthyroidism, patients who died and patients without cardiothyreosis. Results: We included 100 adult patients (43 men and 57 women). The mean age was 49.3 ±12.9 years (20-79 years). The diagnosis of cardiothyreosis was concomitant with that of hyperthyroidism in 72% of cases. Weight loss and palpitations were the two most frequently reported signs in 91% of cases each. Hypertension was systolic in 15 patients. The average heart rate was 103.1 beats/min (52-182 bpm). The mean TSH and FT4 levels were 0.042 μIU/ml and 59.6 pmol/l, respectively. Rhythm disorders and heart failure were the most common cardiac complications with 81 and 56 cases, respectively. Cardiac ultrasound showed dilatation of the left atrium in 28.3% of patients. Pulmonary arterial hypertension was present in 43% of cases. 57 patients had been treated with benzylthiouracil at a mean dose of 157.45 mg/day. Radical treatment with radioactive iodine was indicated in 81 patients. The evolution of cardiothyreosis was favourable in 58 patients. Conclusion: Cardiothyreosis is a serious complication of hyperthyroidism. Future prospective studies will be of great help to better characterise and manage cardiothyreosis.

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