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A Prospective Comparative Study on Improvement of Hyperthyroid Cardiovascular Dysfunction in Patients Undergoing

S Muthukumar1,2, K Ravikumar3,4, S Dhalapathy3,5

  • 1Department of Endocrine Surgery, Madurai Medical College, Madurai, India. docmuthukumar@yahoo.com.

World Journal of Surgery
|March 14, 2018
PubMed

Insights

Total thyroidectomy effectively reverses cardiovascular dysfunction in hyperthyroidism patients, particularly diastolic dysfunction. Antithyroid drugs show less significant improvement over six months.

Area of Science:

  • Cardiology
  • Endocrinology
  • Internal Medicine

Background:

  • Cardiovascular dysfunction (CVD) is a major complication and cause of mortality in hyperthyroidism.
  • Few studies have compared CVD outcomes across different hyperthyroidism treatment modalities.

Purpose of the Study:

  • To compare the effectiveness of total thyroidectomy versus antithyroid medications in reversing cardiovascular dysfunction in hyperthyroid patients.

Main Methods:

  • Prospective study comparing 123 patients undergoing total thyroidectomy (Group I) with 42 patients treated with antithyroid medications (Group II).
  • Cardiovascular function assessed via 2D echocardiography and serum NT-pro-BNP at diagnosis, post-euthyroidism, and 6 months post-treatment.
  • A control group of 40 patients with benign thyroid nodules undergoing total thyroidectomy was included.

Main Results:

  • At 6 months post-treatment, 95.9% of patients in Group I showed dramatic improvement in CVD, compared to 78.5% in Group II.
  • Significant improvement in diastolic dysfunction parameters was observed in the total thyroidectomy group (Group I) but not in the antithyroid medication group (Group II).
  • No significant difference in systolic dysfunction was noted between the groups at 6 months.

Conclusions:

  • Total thyroidectomy is the preferred treatment for hyperthyroid cardiac dysfunction, leading to complete reversal of diastolic dysfunction within six months.
  • Antithyroid medications are less effective in fully resolving cardiovascular complications associated with hyperthyroidism.
Abstract

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