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Hemodynamic changes in hyperthyroidism-related pulmonary hypertension: a prospective echocardiographic study
Chung-Wah Siu1, Xue-Hua Zhang, Cindy Yung
1Cardiology Division, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
The Journal of Clinical Endocrinology and Metabolism
|March 1, 2007
Summary
Up to 47% of hyperthyroidism patients develop pulmonary hypertension (PHT), often asymptomatic. This condition, caused by either pulmonary arterial hypertension or pulmonary venous hypertension, is reversible after treatment to a euthyroid state.
Area of Science:
- Cardiology
- Endocrinology
- Pulmonology
Background:
- Emerging evidence links hyperthyroidism with pulmonary hypertension (PHT).
- Mechanisms and clinical significance of this association require elucidation.
Purpose of the Study:
- Determine PHT prevalence in hyperthyroidism.
- Analyze associated hemodynamic changes and patient outcomes.
Main Methods:
- Serial echocardiography in 75 hyperthyroid patients and 35 controls.
- Assessed pulmonary artery systolic pressure (PASP), cardiac output (CO), total vascular resistance (TVR), and left ventricular (LV) filling pressure.
- Evaluated changes before and 6 months after antithyroid treatment.
Main Results:
- 47% of hyperthyroid patients had PHT (PASP ≥ 35 mm Hg).
- PHT patients exhibited higher CO, PASP, and LV filling pressures compared to controls.
- PHT comprised pulmonary arterial hypertension (PAH) in 71% and pulmonary venous hypertension (PVH) in 29%.
Conclusions:
- Hyperthyroidism is associated with significant PHT prevalence in patients with normal LV systolic function.
- PHT is driven by increased CO (PAH) or elevated LV filling pressures (PVH).
- Hyperthyroidism-related PHT is largely asymptomatic and reversible upon achieving a euthyroid state.
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