Related Experiment Video
Updated: Mar 29, 2026
Minimal Invasive Resection of Large Retrosternal Thyroid Goiter
Published on: September 20, 2024
A Prospective Study on Cardiovascular Dysfunction in Patients with Hyperthyroidism and Its Reversal After Surgical
Sankaran Muthukumar1, Dhalapathy Sadacharan2, Krishnan Ravikumar2
1Department of Endocrine Surgery, Madras Medical College, Chennai, India. docmuthukumar@yahoo.com.
Insights
Hyperthyroidism commonly causes cardiovascular dysfunction, including pulmonary hypertension, which significantly improves after total thyroidectomy. Serum NT-proBNP levels effectively monitor these cardiac changes and their recovery.
Area of Science:
- Cardiology
- Endocrinology
- Thyroidology
Background:
- Cardiovascular dysfunction (CVD) is a significant complication of hyperthyroidism, impacting mortality and morbidity.
- The reversibility of CVD after total thyroidectomy (TT) requires further investigation.
Purpose of the Study:
- To evaluate the effects of hyperthyroidism on myocardial function.
- To assess the reversibility of cardiac dysfunction following total thyroidectomy.
Main Methods:
- A prospective case-control study involving 41 hyperthyroid patients (Group A) and 20 controls (Group B).
- Evaluations included 2D Echocardiography and serum NT-proBNP at diagnosis, after achieving euthyroidism, and 3 months post-TT.
Main Results:
- At diagnosis, 63.4% of hyperthyroid patients exhibited CVD, with pulmonary hypertension (PHT) in 58.5%, dilated cardiomyopathy (DCM) in 19.5%, and heart failure in 9.7%.
- Significant improvements were observed post-thyroidectomy: PHT reversed in 95.8%, DCM in 87.5%, and heart failure in 100% of cases.
- Elevated NT-proBNP levels at diagnosis decreased substantially after TT, correlating with CVD severity.
Conclusions:
- Pulmonary hypertension is the most common cardiac event in hyperthyroidism and is fully reversible within 3 months of TT.
- Total thyroidectomy leads to consistent improvement in various CVD parameters.
- Serum NT-proBNP serves as a valuable objective marker for monitoring hyperthyroid cardiac dysfunction and its response to treatment.
Background:
Cardiovascular dysfunction (CVD) is a major cause of mortality and morbidity in hyperthyroidism. CVD and its reversibility after total thyroidectomy (TT) are not adequately addressed. This prospective case-control study evaluates the effect of hyperthyroidism on myocardium and its reversibility after TT.
Materials And Methods:
Surgical candidates of new onset hyperthyroidism, Group A (n = 41, age < 60 years) was evaluated with 2D Echocardiography, serum n-terminal probrain natriuretic peptide (NT-proBNP) at the time of diagnosis (Point A), after achieving euthyroidism (Point B) with antithyroid drugs, and 3 months after TT (Point C). 20 patients with nontoxic benign thyroid nodules undergoing TT served as controls (Group B).
Results:
Both groups were age and sex matched. Group A (n = 41) comprises Graves disease (n = 22) and Toxic Multinodular goiter (n = 19). At point A, CVD was evident in 26/41(63.4%), pulmonary hypertension (PHT) in 24/41(58.5%)--mild in 17/41(41.4%) and moderate in 7/41(17%)--dilated cardiomyopathy (DCM) in 8/41(19.5%), heart failure in 4/41(9.7%), and NT-proBNP elevated in 28/41(68.3%). At point B, recovery was observed in PHT 19/26(73.1%), DCM 4/8(50%), heart failure 4/4(100%), NT-proBNP in 3/28(10.7%). At Point C, further improvement occurred in PHT 23/24(95.8%), DCM 7/8(87.5%), heart failure 4/4(100%), and NT-proBNP in 24/28(85.7%).
Conclusion:
Pulmonary hypertension is completely reversible at 3 months after TT and is the most common cardiac event in Hyperthyroidism. Various parameters of CVD improved consistently after surgical cure. NT-proBNP levels correlated well with the severity and duration of CVD and hence can be an objective tool in monitoring of hyperthyroid cardiac dysfunction.
Related Concept Videos
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
01:25Aortic Regurgitation III: Medical Management
01:30Hypertension III: Clinical Manifestations and Diagnostic Studies
01:20Synthesis and Regulation of Thyroid Hormones
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
01:29Cardiomyopathy V: Interprofessional Care