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Prevalence and Risk Factors of Left Ventricular Diastolic Dysfunction in Patients With Hyperthyroidism

Huan Li^1,2, Renli Zeng^1,2, Yunfei Liao^1,2

¹Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Frontiers in Endocrinology

|January 25, 2021

Insights

Left ventricular diastolic dysfunction is common in hyperthyroid patients, especially older and overweight individuals. Age and BMI are key risk factors, not thyroid hormone levels, highlighting the need for focused diastolic function assessment.

Area of Science:

Cardiology
Endocrinology
Echocardiography

Background:

Left ventricular (LV) diastolic dysfunction predicts future heart failure.
Overt hyperthyroidism is linked to severe heart complications.
The relationship between hyperthyroidism and diastolic dysfunction is unclear, with limited data on prevalence and risk factors.

Purpose of the Study:

To determine the prevalence of LV diastolic dysfunction in overt hyperthyroidism.
To identify risk factors associated with LV diastolic dysfunction in this population.

Main Methods:

Compared 388 overt hyperthyroid patients with 388 matched euthyroid controls.
Assessed LV diastolic function using traditional and tissue-Doppler echocardiography.
Collected clinical and echocardiographic data for analysis.

Main Results:

LV diastolic dysfunction prevalence was 35.1% in hyperthyroid patients vs. 25.5% in controls (P=0.003).
Prevalence increased with age and BMI.
Overweight/obesity (OR=3.024) and older age groups (ORs 2.976-24.966) were significantly associated with diastolic dysfunction, while hypertension, diabetes, eGFR, and thyroid hormone levels were not.

Conclusions:

LV diastolic dysfunction is highly prevalent in overt hyperthyroidism, particularly in older, overweight, or obese individuals.
Age and BMI are independent risk factors for LV diastolic dysfunction.
Clinical focus should include LV diastolic function in hyperthyroid patients, especially those who are older or have elevated BMI.

Read full analysis

Abstract

Background:

Left ventricular (LV) diastolic dysfunction has been demonstrated to be an independent predictor of the future heart failure. Heart failure is one of the severe complications caused by overt hyperthyroidism. However, the effects of overt hyperthyroidism on diastolic dysfunction are conflicting, and little is known about the prevalence and risk factors of the diastolic dysfunction in patients with overt hyperthyroidism.

Methods:

A total of 388 patients with overt hyperthyroidism were included and compared with 388 age- and gender- matched euthyroid control subjects. LV diastolic function was evaluated by traditional and tissue-Doppler echocardiography. Routine clinical medical data and echocardiographic parameters were recorded for analysis.

Results:

The prevalence of LV diastolic dysfunction was 35.1% among hyperthyroid patients and significantly higher than control subjects whose prevalence was 25.5% (P = 0.003), and it increased with age and body mass index (BMI) in patients with overt hyperthyroidism. The possible risk factors for LV diastolic dysfunction, such as hypertension, diabetes, decreased estimated glomerular filtration rate (eGFR), and increased level of thyroid hormones weren't associated with LV diastolic dysfunction. However, overweight or obese were significantly associated with LV diastolic dysfunction (OR = 3.024, 95% CI = 1.517-6.027, P = 0.002) compared with normal BMI. When compared with age <40 years old group, 40-50 years old group, 50-60 years old group and age ≥60 years old group were significantly associated with LV diastolic dysfunction, with ORs of 2.976 (95% CI = 1.744-5.019), 12.424 (95% CI = 4.934-31.283), 24.966 (95% CI = 5.975-104.321), respectively.

Conclusion:

LV diastolic dysfunction was very common, in particular, in older and overweight or obese patients with overt hyperthyroidism. Additionally, age and BMI were independent risk factors for LV diastolic dysfunction, while the level of thyroid hormones was not. Therefore, besides the LV systolic function, we also need focus on the diastolic function in patients with overt hyperthyroidism in clinical work, especially the older and overweight or obese patients.

Keywords:

echocardiography hyperthyroidism left ventricular diastolic dysfunction prevalence risk factors

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