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Left ventricular function at rest and during exercise in acute hypothyroidism.

S Wieshammer1, F S Keck, J Waitzinger

  • 1Department of Internal Medicine, University of Ulm Medical Centre, Federal Republic of Germany.

British Heart Journal
|September 1, 1988
PubMed
Summary
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Short-term hypothyroidism affects cardiac performance by altering loading conditions and exercise heart rate, not myocardial contractility. This study investigated cardiac function in hypothyroid patients, finding significant changes in cardiac output and stroke volume.

Area of Science:

  • Cardiology
  • Endocrinology
  • Thyroidology

Background:

  • Thyroid hormones are crucial for cardiovascular function.
  • Hypothyroidism can lead to altered cardiac performance.
  • The specific impact on left ventricular function requires further elucidation.

Purpose of the Study:

  • To investigate the effects of hypothyroidism on left ventricular function at rest and during exercise.
  • To differentiate between changes in loading conditions and intrinsic myocardial contractility in hypothyroid states.

Main Methods:

  • Nine patients post-thyroid cancer treatment underwent radionuclide ventriculography and right heart catheterization.
  • Cardiac function was assessed during both hypothyroid (post-triiodothyronine withdrawal) and euthyroid (thyroxine replacement) states.

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  • Measurements included cardiac output, stroke volume, ejection fraction, and systolic pressure:volume relation.

    • Main Results:

    • Hypothyroidism was associated with lower resting cardiac output, stroke volume, and end-diastolic volume, and higher peripheral resistance.
    • During exercise, heart rate, cardiac output, end-diastolic volume, and stroke volume were lower in the hypothyroid state.
    • Left ventricular ejection fraction and the systolic pressure:volume relation (contractility estimate) showed no significant difference between thyroid states.

    Conclusions:

    • Short-term hypothyroidism primarily affects cardiac performance through altered loading conditions and exercise heart rate.
    • Acute thyroid hormone deficiency does not appear to significantly impair the intrinsic contractile properties of the myocardium.
    • These findings highlight the adaptability of cardiac function to thyroid status changes.