Linear Analysis of Autonomic Activity and Its Correlation with Creatine Kinase-MB in Overt Thyroid Dysfunctions

Abstract

Autonomic activity may be deranged in thyroid dysfunctions and may lead to cardiovascular morbidity and mortality. Myopathy is a common manifestation in thyroid disorders and may be associated with raised serum creatine kinase (CK). We hypothesized that cardiovascular abnormality in thyroid dysfunction may manifest as raised CK-MB. This study was designed to investigate the correlation of CK and its isoform CK-MB with thyroid profile and linear parameters of heart rate variability (HRV). The study was conducted on 35 hypothyroid and hyperthyroid patients each, and 25 age-matched healthy controls. Autonomic activity was assessed by simple short term 5-min HRV. Biochemical evaluation of serum thyroid profile, CK-NAC and CK-MB were estimated in all the subjects. Our results demonstrated low HRV in hypo- as well as hyperthyroid patients. We observed significantly higher serum CK levels in hypothyroid patients when compared to hyperthyroids and controls. However, no significant differences were observed in CK-MB levels in the three groups. Significant positive correlation of CK with TSH and negative correlation with some HRV parameters (LF power, HF power, total power, SDNN, RMSSD) was observed in hypothyroid patients. Whereas correlation of CK-MB with thyroid profile as well as HRV parameters was non-significant in all the groups. Based on the CK and CK-MB findings and their correlation, we conclude that the cardiovascular changes seen in thyroid dysfunctions may primarily be due to autonomic imbalance without apparent cardiac muscle involvement. Whereas, raised CK levels indicate predominantly skeletal muscle involvement in hypothyroid patients.

Cardiac Autonomic Modulation and Anti-Thyroid Peroxidase (TPO) Antibodies in Subclinical Hypothyroidism – Does Any Correlation Exist?

“…The ANS controls the heart through a complex mechanism of interactions between sympathetic and parasympathetic divisions, producing fluctuations in heartbeat intervals. The greater the fluctuations in the beat-to-beat interval, the better the cardiovascular system functions to adapt and respond to internal and external stimuli [7]. Heart rate variability (HRV) is an easy, non-invasive, sensitive, and widely applied method for cardiac autonomic assessment.…”

Cardiac autonomic modulation and anti-TPO antibodies in Subclinical Hypothyroidism – Does any correlation exit?

“…Hence, anti-TPOAb positive SCHypo patients are more prone to cardiac risk than anti-TPOAb negative SCHypo patients, this has been proved further by this study. Low parasympathetic activity has been also proposed as an important risk factor for cardiovascular disease and mortality (Mavai et al, 2018) .…”

“…The thyroid gland and the Autonomic Nervous System (ANS) are closely linked by their effects on the cardiovascular system (Reeves, Fisher, Newman, & Granger, 2016;Mavai 2018). The ANS controls heart by complex mechanism of interactions between its two branches, which produces uctuations in heartbeat intervals.…”

“…Autonomic disturbances are common in patients with overt thyroid diseases, even in subclinical conditions (de Miranda et al, 2018;Mavai 2018) and it has been suggested that clinical impairments in SCHYPO may precede cardiac dysfunctions (Hoshi 2019(Hoshi , 2020. In light of the above, this study was planned to assess the cardiac autonomic functions by HRV parameters in anti-TPOAb positive and anti-TPOAb negative subclinical hypothyroid subjects and to assess the association between presence of anti-TPOAb in SCHypo and sympathovagal imbalance (SVI).…”

Laboratory-Instrumental Comparisons of Cardiac Rhythm Variability in Newborns Following Hypoxia

“…У доступній літературі описано спроби поєднаного аналізу показників ВСР та біохімічних маркерів стану міокарда з метою вивчення стану ССС та визначення прогнозу щодо ризику розвитку несприятливих серцевих подій серед дорослої популяції [22][23][24][25][26][27][28]. Проте інформації щодо застосування такої практики у пацієнтів в неонатальний період в доступній літературі нами не отримано.…”