Prospective echocardiographic evaluation of patients with endogenous subclinical hyperthyroidism and after restoring euthyroidism

Kamiński, Grzegorz; Michałkiewicz, Dariusz; Makowski, Karol; Podgajny, Zbigniew; Szalus, Norbert; Ruchała, Marek; Szczepanek, Ewelina; Gielerak, Grzegorz

doi:10.1111/j.1365-2265.2010.03957.x

Cited by 38 publications

(45 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Few studies have assessed the potential beneficial effects of TSH normalization on quality of life and cardiovascular and skeletal risk in SHyper.Some studiessuggest that cardioselective β-blockers [47,48] or treatment of SHyper with ATDs [46,67] may improve symptoms, heart rate and supraventricular arrhythmias in patients with grade 2 SHyper. A prospective study showed a significant improvement of cardiovascular parameters after treatment of hyperthyroidism [67].…”

Section: Treatment Of Endo Shyper: Effects Of Treatment With Atds Andmentioning

confidence: 99%

“…A prospective study showed a significant improvement of cardiovascular parameters after treatment of hyperthyroidism [67]. However, no long-term prospective controlled trials have assessed whether treatment reduces the risk of AF and other cardiovascular events.…”

Section: Treatment Of Endo Shyper: Effects Of Treatment With Atds Andmentioning

confidence: 99%

“…Moreover, prolonged exposure to thyroid hormone excess induces cardiomyocyte hypertrophy by increasing cardiac workload and acting on intracellular signalling pathways [2,3,5,45,46,64,65,66,67]. In young adults with undetectable serum TSH levels, SHyper may increase left ventricular mass, arterial stiffness and left atrial size, and may induce diastolic dysfunction and impair left ventricular performance [45,46,67]. These alterations may be reversible or improve when euthyroidism is restored because thyroid hormone excess does not induce cardiac fibrosis [68].…”

Section: Risks Associated With Persistent and Untreated Endo Subclinimentioning

confidence: 99%

See 2 more Smart Citations

The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism

Biondi¹,

Bartalena²,

Cooper³

et al. 2015

Eur Thyroid J

244

157

View full text Add to dashboard Cite

Endogenous subclinical hyperthyroidism (SHyper) is caused by Graves' disease, autonomously functioning thyroid nodules and multinodular goitre. Its diagnosis is based on a persistently subnormal serum thyroid-stimulating hormone (TSH) level with free thyroid hormone levels within their respective reference intervals. In 2014 the European Thyroid Association Executive Committee, given the controversies regarding the treatment of Endo SHyper, formed a task force to develop clinical practice guidelines based on the principles of evidence-based medicine. The task force recognized that recent meta-analyses, including those based on large prospective cohort studies, indicate that SHyper is associated with increased risk of coronary heart disease mortality, incident atrial fibrillation, heart failure, fractures and excess mortality in patients with serum TSH levels <0.1 mIU/l (grade 2 SHyper). Therefore, despite the absence of randomized prospective trials, there is evidence that treatment is indicated in patients older than 65 years with grade 2 SHyper to potentially avoid these serious cardiovascular events, fractures and the risk of progression to overt hyperthyroidism. Treatment could be considered in patients older than 65 years with TSH levels 0.1-0.39 mIU/l (grade 1 SHyper) because of their increased risk of atrial fibrillation, and might also be reasonable in younger (<65 years) symptomatic patients with grade 2 SHyper because of the risk of progression, especially in the presence of symptoms and/or underlying risk factors or co-morbidity. Finally, the task force concluded that there are no data to support treating SHyper in younger asymptomatic patients with grade 1 SHyper. These patients should be followed without treatment due to the low risk of progression to overt hyperthyroidism and the weaker evidence for adverse health outcomes.

show abstract

Section: Treatment Of Endo Shyper: Effects Of Treatment With Atds Andmentioning

confidence: 99%

Section: Treatment Of Endo Shyper: Effects Of Treatment With Atds Andmentioning

confidence: 99%

Section: Risks Associated With Persistent and Untreated Endo Subclinimentioning

confidence: 99%

See 1 more Smart Citation

The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism

Biondi¹,

Bartalena²,

Cooper³

et al. 2015

Eur Thyroid J

244

157

View full text Add to dashboard Cite

show abstract

“…Sgarbi 37 and Kaminski 40 performed similar analyses of cardiac disturbances before and after treatment of SH, using similar methods and arriving at concordant results. Both propose an early therapy of the SH, in order to prevent cardiac dysfunction and progression to advanced disease and to more concerning clinical effects.…”

Section: B Cardiovascular Effectsmentioning

confidence: 99%

“…Very recently Kaminski et al 40 evaluated the impact of SH in the heart through echocardiographic parameters. Patients were subjected to treatment with radio-iodine therapy.…”

Section: B Cardiovascular Effectsmentioning

confidence: 99%

Clinical and therapeutic controversies on subclinical hyperthyroidism

Salles¹,

Salles²

2014

Medical Express

View full text Add to dashboard Cite

Subclinical hyperthyroidism is defined as low or undetectable serum thyrotropin concentration in the presence of levels of free thriiodothyronine and thyroxine within the reference range. Despite the conflicting results from many observational studies, this thyroid disorder has been associated with an increased risk of developing atrial fibrillation, left ventricular hypertrophy, increased heart rate and diastolic function impairment. In addition, a relation between subclinical hyperthyroidism, skeletal disorders and cognitive changes has been reported. Treatment of subclinical hyperthyroidism remains controversial, given the lack of prospective randomized studies showing clinical benefits with restoration of the euthyroid state. Nevertheless, this review recommends the treatment of subclinical hyperthyroidism to individuals aged over 65, postmenopausal women, patients with cardiac risk factors, heart disease, osteoporosis or hyperthyroidism symptoms, whenever TSH is persistently suppressed (,0.1 mU/L). When TSH is between 0.1 -0.5 mU/L, treatment should be considered for individuals over age 65, patients with heart disease or hyperthyroidism symptoms.

show abstract

Four‐dimensional speckle tracking echocardiography and fragmented QRS in detection of early left ventricular systolic dysfunction in patients with subclinical hyperthyroidism

Karaca¹,

Karasu²,

Taşolar

et al. 2023

J of Clinical Ultrasound

View full text Add to dashboard Cite

Background Thyroid disorders are associated with many cardiovascular risk factors. The importance of thyroid hormones in the pathophysiology of heart failure is underlined by the European guidelines of the European Society of Cardiology. However, the role of subclinical hyperthyroidism (SCH) in subclinical left ventricular (LV) systolic dysfunction is not entirely clear. Methods This cross‐sectional study included 56 SCH patients and 40 healthy volunteers. The 56 SCH group was divided into two subgroups depending on the presence of fragmented QRS (fQRS). In both groups, left ventricular global area strain (LV‐GAS), global radial strain (GRS), global longitudinal strain (GLS), and global circumferential strain (GCS) were obtained with four‐dimensional (4D) echocardiography. Results GAS, GRS, GLS, and GCS values were significantly different in SCH patients and in healthy volunteers. GLS and GAS values were lower in the fQRS+ than in the fQRS− group (−17.06 ± 1.00 vs. −19.08 ± 1.71, p < .001, and −26.61 ± 2.38 vs. −30.61 ± 2.57, p < .001, respectively). ProBNP was positively correlated with LV‐GLS (r = 0.278, p = .006) and LV‐GAS (r = 0.357, p < .001). Multiple linear regression analysis showed that fQRS was an independent predictor of LV‐GAS. Conclusions 4D strain echocardiography may be helpful for the prediction of early cardiac dysfunction in patients with SCH. The presence of fQRS may be an indicator of subclinical LV dysfunction in SCH.

show abstract

Prospective echocardiographic evaluation of patients with endogenous subclinical hyperthyroidism and after restoring euthyroidism

Abstract: sHT was associated with significant changes in echocardiographic parameters, which may contribute to increased cardiovascular risk in these patients. The alterations were reversible with restoring biochemical euthyroidism, what supports the necessity of treatment introduction in sHT.

Cited by 38 publications

References 35 publications

The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism

The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism

Clinical and therapeutic controversies on subclinical hyperthyroidism

Four‐dimensional speckle tracking echocardiography and fragmented QRS in detection of early left ventricular systolic dysfunction in patients with subclinical hyperthyroidism

Contact Info

Product

Resources

About