Abstract
BackgroundLeft ventricular (LV) diastolic dysfunction has been demonstrated to be an independent predictor of the future heart failure. Heart failure is one of the severe complications caused by overt hyperthyroidism. However, the effects of overt hyperthyroidism on diastolic dysfunction are conflicting, and little is known about the prevalence and risk factors of the diastolic dysfunction in patients with overt hyperthyroidism.MethodsA total of 388 patients with overt hyperthyroidism were included and compared with 388 age- and gender- matched euthyroid control subjects. LV diastolic function was evaluated by traditional and tissue-Doppler echocardiography. Routine clinical medical data and echocardiographic parameters were recorded for analysis.ResultsThe prevalence of LV diastolic dysfunction was 35.1% among hyperthyroid patients and significantly higher than control subjects whose prevalence was 25.5% (P = 0.003), and it increased with age and body mass index (BMI) in patients with overt hyperthyroidism. The possible risk factors for LV diastolic dysfunction, such as hypertension, diabetes, decreased estimated glomerular filtration rate (eGFR), and increased level of thyroid hormones weren’t associated with LV diastolic dysfunction. However, overweight or obese were significantly associated with LV diastolic dysfunction (OR = 3.024, 95% CI = 1.517–6.027, P = 0.002) compared with normal BMI. When compared with age <40 years old group, 40-50 years old group, 50-60 years old group and age ≥60 years old group were significantly associated with LV diastolic dysfunction, with ORs of 2.976 (95% CI = 1.744–5.019), 12.424 (95% CI = 4.934–31.283), 24.966 (95% CI = 5.975–104.321), respectively.ConclusionLV diastolic dysfunction was very common, in particular, in older and overweight or obese patients with overt hyperthyroidism. Additionally, age and BMI were independent risk factors for LV diastolic dysfunction, while the level of thyroid hormones was not. Therefore, besides the LV systolic function, we also need focus on the diastolic function in patients with overt hyperthyroidism in clinical work, especially the older and overweight or obese patients.
Highlights
Hyperthyroidism is one of the most common endocrine diseases, affecting 0.2%–1.3% of the people in iodine-sufficient places of the world [1], which constitutes a major health issue due to its prominent association with cardiovascular diseases, including congestive heart failure, atrial fibrillation, and pulmonary hypertension and so on [2, 3].Studies showed that approximately 6% of patients with overt hyperthyroidism developed congestive heart failure [4], but only 50% of them had left ventricular (LV) systolic dysfunction
A total of 388 patients diagnosed with overt hyperthyroidism and 388 age- and gender- matched euthyroid control subjects were included in this study according to the inclusion and exclusion criteria
Compared with age
Summary
Studies showed that approximately 6% of patients with overt hyperthyroidism developed congestive heart failure [4], but only 50% of them had left ventricular (LV) systolic dysfunction. Besides LV systolic dysfunction, LV diastolic dysfunction has been demonstrated to be an independent predictor of the future heart failure [5,6,7]. LV diastolic dysfunction may account for part of reasons for heart failure in patients with overt hyperthyroidism. There are few data on the prevalence of LV diastolic dysfunction in patients with overt hyperthyroidism. Left ventricular (LV) diastolic dysfunction has been demonstrated to be an independent predictor of the future heart failure. Heart failure is one of the severe complications caused by overt hyperthyroidism. The effects of overt hyperthyroidism on diastolic dysfunction are conflicting, and little is known about the prevalence and risk factors of the diastolic dysfunction in patients with overt hyperthyroidism
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