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Reversible diastolic dysfunction after long-term exogenous subclinical hyperthyroidism: a randomized,

J W A Smit1, C F A Eustatia-Rutten, E P M Corssmit

  • 1Leiden University Medical Center, Department of Endocrinology, P.O. Box 9600, 2300 RC, Leiden, The Netherlands. jwasmit@lumc.nl

The Journal of Clinical Endocrinology and Metabolism
|September 1, 2005
PubMed
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Long-term subclinical hyperthyroidism causes diastolic dysfunction, which can be reversed by restoring normal thyroid hormone levels (euthyroidism). This finding is clinically significant due to the association of diastolic dysfunction with increased mortality.

Area of Science:

  • Cardiology
  • Endocrinology
  • Thyroidology

Background:

  • Subclinical hyperthyroidism is linked to cardiac dysfunction, but reversibility remains unclear.
  • Exogenous subclinical hyperthyroidism, often due to thyroid hormone therapy, provides a model to study these effects.

Purpose of the Study:

  • To investigate cardiac abnormalities in patients with long-term exogenous subclinical hyperthyroidism.
  • To determine if these cardiac abnormalities are reversible upon achieving euthyroid state.

Main Methods:

  • A 6-month, prospective, single-blinded, placebo-controlled randomized trial was conducted.
  • 25 patients with a history of differentiated thyroid carcinoma on TSH-suppressive L-T4 therapy were studied.
  • Echocardiography with tissue Doppler assessed left ventricular function and diastolic parameters.

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Main Results:

  • Patients exhibited impaired diastolic function at baseline compared to controls.
  • Restoring euthyroidism in the study group led to significant improvements in diastolic function parameters.
  • Left ventricular mass index was increased at baseline but not improved by euthyroidism.

Conclusions:

  • Prolonged subclinical hyperthyroidism is associated with reversible diastolic dysfunction.
  • Restoration of euthyroidism significantly improves cardiac diastolic function.
  • The reversibility of diastolic dysfunction holds clinical significance due to mortality risks.