Pulmonary Arterial Hypertension in Graves’ Disease

Abstract

Background: Cardiovascular manifestations in Graves’ disease (GD) occur frequently with various phenotypes. A link between GD and pulmonary hypertension has been reported. There is limited data about prevalence PAH and related factors in GD in Indonesia. Objective: To identify the prevalence and related factors of PAH in GD. Method: This retrospective study is using secondary data from transthoracic echocardiographic database of General Hospital since last year. PAH was measured by continuous-wave Doppler echocardiography (pulmonary artery systolic pressure >35 mmHg). Sixty five patients who were diagnosed as GD were enrolled to study participant. Results: Of 65 eligible participants consist of 52 female and 13 male and median ages 42 year old (18–66 year old). Cardiac abnormalities were encountered in 79% participant of which consist of PAH in 15.4%. The patients with pulmonary hypertension had significantly higher pulmonary vascular resistance (PVR), cardiac output compared to those without (p < 0.001 and p < 0.021 respectively). The possible explanations in addition to the effect of thyroid hormone on the cardiovascular system, autoimmune-mediated pulmonary vascular remodeling may play a role in Graves’ disease-linked elevated pulmonary artery systolic pressure. Conclusion: The prevalence of PAH in GD was 15.4%. There is still needed future research to know the factors related to PAH especially related to clinical and laboratory abnormalities in GD.