Hyperdynamic right heart function in Graves’ hyperthyroidism measured by echocardiography normalises on restoration of euthyroidism
File version
Accepted Manuscript (AM)
Author(s)
Inder, WJ
Stowasser, M
Stanton, T
Griffith University Author(s)
Primary Supervisor
Other Supervisors
Editor(s)
Date
Size
File type(s)
Location
Abstract
Background: Graves’ hyperthyroidism commonly causes tachycardia and may result in pulmonary hypertension and high output cardiac failure. There is limited information regarding the effect of treatment on cardiac function measured using modern echocardiographic techniques. Methods: Eight individuals with Graves’ hyperthyroidism, aged 22–64 years, underwent comprehensive transthoracic echocardiography at three time points: before treatment, two weeks after commencement of carbimazole, and at six months or more when euthyroid. Exercise capacity was assessed using the 6-minute-walk-distance (6MWT), and quality of life was assessed by Medical Outcome Study 36-item Short-Form Health Status Survey. Results: All individuals were rendered euthyroid by final assessment. At presentation, there was evidence of hyperdynamic right ventricular function as measured by peak systolic velocity of the free wall of the tricuspid annulus, tricuspid annular plane systolic excursion and right ventricular ejection fraction, which normalised after resolution of thyrotoxicosis. Baseline heart rate correlated significantly with severity of the thyrotoxicosis for either free T4 (r = 0.91, p = 0.01) or free T3 (r = 0.94, p = 0.001). No individual had measurable pulmonary hypertension. Cardiac output was significantly lower in the euthyroid compared to the thyrotoxic state (p = 0.03). A higher baseline TSH-receptor antibody titre corresponded to a greater improvement in exercise capacity (r = 0.76, p < 0.05) and physical quality of life (r = 0.73, p < 0.05) on resolution of the hyperthyroidism. Conclusion: Graves’ hyperthyroidism causes increased cardiac output and a hyperdynamic right ventricle which normalise on restoration of the euthyroid state.
Journal Title
Heart, Lung and Circulation
Conference Title
Book Title
Edition
Volume
26
Issue
6
Thesis Type
Degree Program
School
Publisher link
Patent number
Funder(s)
Grant identifier(s)
Rights Statement
Rights Statement
© 2017. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
Item Access Status
Note
Access the data
Related item(s)
Subject
Cardiovascular medicine and haematology
Health services and systems
Public health
Graves
Pulmonary hypertension
Right heart function
Strain
TAPSE
Persistent link to this record
Citation
Teasdale, SL; Inder, WJ; Stowasser, M; Stanton, T, Hyperdynamic right heart function in Graves’ hyperthyroidism measured by echocardiography normalises on restoration of euthyroidism, Heart, Lung and Circulation, 2017, 26 (6), pp. 580-585