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Cardiac involvement in thyroid hormone resistance.

George J Kahaly1, Clare H Matthews, Susanne Mohr-Kahaly

  • 1Department of Endocrinology/Metabolism, Gutenberg University Hospital, Mainz 55101, Germany. kahaly@endokrinologie.klinik.uni-mainz.de

The Journal of Clinical Endocrinology and Metabolism
|January 15, 2002
PubMed
Summary

Resistance to thyroid hormone (RTH) shows a modulated hyperthyroid effect on the heart, with incomplete cardiac response observed. Cardiovascular changes in RTH are less pronounced than in hyperthyroidism or hypothyroidism.

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Area of Science:

  • Endocrinology
  • Cardiology
  • Molecular Biology

Background:

  • Resistance to thyroid hormone (RTH) is a rare genetic disorder characterized by reduced sensitivity of target tissues to thyroid hormones.
  • Cardiovascular manifestations are a key feature of RTH, but their precise nature and extent require further elucidation.

Purpose of the Study:

  • To investigate cardiovascular alterations in patients with resistance to thyroid hormone (RTH).
  • To compare cardiac function in RTH patients with those suffering from hyperthyroidism, hypothyroidism, and healthy controls.

Main Methods:

  • Two-dimensional and Doppler echocardiography were employed to assess cardiac involvement in 54 RTH patients.
  • Data from RTH subjects were compared with hyperthyroid, hypothyroid, and healthy euthyroid individuals.

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Main Results:

  • RTH children exhibited higher heart rate and lower left ventricular ejection fraction compared to healthy children.
  • RTH patients displayed increased heart rate, cardiac output, and stroke volume, but lower LV ejection and shortening fractions compared to hyperthyroid patients.
  • Diastolic parameters were altered in RTH, with shorter isovolumic relaxation and deceleration times compared to controls and hypothyroid patients.

Conclusions:

  • Findings suggest a modulated hyperthyroid effect on cardiac systolic and diastolic function in RTH.
  • The cardiovascular changes in RTH indicate an incomplete cardiac response to thyroid hormone.
  • Left ventricular ejection and shortening fractions, systolic diameter, and LV wall thickness in RTH were comparable to healthy controls.