Abstract
BackgroundThis study was to investigate the influence of thyroid stimulating hormone (TSH) suppression time on the cardiac function of differentiated thyroid carcinoma (DTC) patients.Methods105 DTC patients were divided into strict TSH suppression group (model group, TSH ≤ 0.1 mU/L) and general TSH suppression group (control group, TSH > 0.1 mU/L). According to the suppression time, these two groups were respectively divided into three groups: group within half a year, group between half a year and a year and group more than a year. Gated myocardial perfusion imaging was applied to observe differences of left ventricle (LV) myocardial perfusion, LV diastolic and systolic function and LV systolic synchrony in every group.ResultsThe left ventricular diastolic function, systolic synchrony and myocardial perfusion level of model group decreased with prolonged suppression time. The values of left ventricular EF, PFR and BPM in patients less than half a year were higher than those in 6 months to 1 year for control group.ConclusionThyroid stimulating hormone suppression can influence the cardiac function of patients and with the prolongation of suppression time, regardless of the level of TSH suppression, the possibility of cardiac function depression in patients will increase. TSH may lower the risk of cardiovascular disease in high-risk patients than those in TSH patients with moderate or low risk. The drugs improving cardiac function should be used cooperatively in different suppression period to decrease the occurrence rate of cardiac adverse reactions.
Highlights
This study was to investigate the influence of thyroid stimulating hormone (TSH) suppression time on the cardiac function of differentiated thyroid carcinoma (DTC) patients
EF ejection fraction, PER peak ejection rate, EDV end-diastolic volume, PFR peak filling rate, MFR/3 mean filling rate over the first third of the end-systolic to end diastolic phase, TTPF time to peak filling from end-systole, BMP beats per minute, STD standard deviation, Summed rest score (SRS) summed rest score difference was statistically significant (P < 0.05), there was no notable difference on other cardiac function indexes
EF ejection fraction, PER peak ejection rate, EDV end-diastolic volume, PFR peak filling rate, MFR/3 mean filling rate over the first third of the end-systolic to end diastolic phase, TTPF time to peak filling from end-systole, BMP beats per minute, STD standard deviation, SRS summed rest score of left ventricle (LV) diastolic and systolic function, myocardial perfusion level and myocardial systolic synchrony in group E and group F
Summary
This study was to investigate the influence of thyroid stimulating hormone (TSH) suppression time on the cardiac function of differentiated thyroid carcinoma (DTC) patients. A research in Japan showed no difference in disease free survival between patients with TSH suppression < 0.1 mU/L and patients with TSH suppression > 0.1 mU/L. Other research showed TSH suppression < 0.1 mU/L could significantly improve the prognostic recovery of patients with high-risk thyroid cancer [7, 8] In this investigation, gated myocardial perfusion imaging (GMPI) [9] was applied to observe the influence of different TSH suppression levels and TSH suppression time on cardiac function from the perspective of left ventricle (LV) myocardial perfusion, LV diastolic and systolic function and LV systolic synchrony so
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