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Impact of Hyperthyroidism on the Cardiovascular and Musculoskeletal Systems and Management of Patients with Subclinical Graves’ Disease

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Graves' Disease
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Abstract

An increased cardiovascular morbidity and mortality have been linked with overt and subclinical hyperthyroidism. These findings might be the consequence of the increased risk of atrial fibrillation, embolic events, heart failure, and coronary disease observed in the presence of thyroid hormone excess. A specific autoimmune cardiovascular involvement has been reported in patients with Graves’ disease. Pulmonary hypertension, cardiac valve disease, and dilated cardiomyopathy represent important risk factors, which may play an important role in determining the poor cardiovascular outcome reported in autoimmune hyperthyroidism. The correction of overt and subclinical hyperthyroidism should be the first step in improving the prognosis of hyperthyroid patients with cardiovascular complications.

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References

  1. Cooper DS. Hyperthyroidism. Lancet. 2003;362:459–68.

    CAS  PubMed  Google Scholar 

  2. Brent GA. Clinical practice. Graves’ disease. N Engl J Med. 2008;358:2594–605.

    CAS  PubMed  Google Scholar 

  3. Bahn RS. Graves’ ophthalmopathy. N Engl J Med. 2010;362(8):726–38.

    PubMed Central  CAS  PubMed  Google Scholar 

  4. Jenkins RC, Weetman AP. Disease associations with autoimmune thyroid disease. Thyroid. 2002;12(11):977–88.

    PubMed  Google Scholar 

  5. Laurberg P, Pedersen KM, Vestergaard H, Sigurdsson G. High incidence of multinodular toxic goitre in the elderly population in a low iodine intake area vs. high incidence of Graves’ disease in the young in a high iodine intake area: comparative surveys of thyrotoxicosis epidemiology in East-Jutland Denmark and Iceland. J Intern Med. 1991;229:415–20.

    CAS  PubMed  Google Scholar 

  6. Brix TH, Kyvik KO, Christensen K, Hegedüs L. Evidence for a major role of heredity in Graves’ disease: a population-based study of two Danish twin cohorts. J Clin Endocrinol Metab. 2001;86:930–4.

    CAS  PubMed  Google Scholar 

  7. Brand OJ, Gough SCL. Genetics of thyroid autoimmunity and the role of the TSHR. Mol Cell Endocrinol. 2010;322:135–43.

    CAS  PubMed  Google Scholar 

  8. Morshed SA, Latif R, Davies TF. Delineating the autoimmune mechanisms in Graves’ disease. Immunol Res. 2012;54:191–203.

    CAS  PubMed  Google Scholar 

  9. Madden PA, Pedersen NL, Kaprio J, Koskenvuo MJ, Martin NG. The epidemiology and genetics of smoking initiation and persistence: cross cultural comparisons of twin study results. Twin Res. 2004;7:82–97.

    PubMed  Google Scholar 

  10. Laurberg P, Wallin G, Tallstedt L, Abraham-Nordling M, Lundell G, Tørring O. TSH-receptor autoimmunity in Graves’ disease after therapy with anti-thyroid drugs, surgery, or radioiodine: a 5-year prospective randomized study. Eur J Endocrinol. 2008;158:69–75.

    CAS  PubMed  Google Scholar 

  11. Biondi B, Kahaly GJ. Cardiovascular involvement in patients with different causes of hyperthyroidism. Nat Rev Endocrinol. 2010;6:431–43.

    PubMed  Google Scholar 

  12. Codaccioni JL, Orgiazzi J, Blanc P, Pugeat M, Roulier R, Carayon P. Lasting remissions in patients treated for Graves’ hyperthyroidism with propranolol alone: a pattern of spontaneous evolution of the disease. J Clin Endocrinol Metab. 1988;67:656–62.

    CAS  PubMed  Google Scholar 

  13. Díez JJ. Hyperthyroidism in patients older than 55 years: an analysis of the etiology and management. Gerontology. 2003;49(5):316–23.

    PubMed  Google Scholar 

  14. Völzke H, Schwahn C, Wallaschofski H, Dörr M. The association of thyroid dysfunction with all-cause and circulatory mortality: is there a causal relationship? J Clin Endocrinol Metab. 2007;7(92):2421–9.

    Google Scholar 

  15. Brandt F, Green A, Hegedüs L, Brix TH. A critical review and meta-analysis of the association between overt hyperthyroidism and mortality. Eur J Endocrinol. 2011;165:491–7.

    CAS  PubMed  Google Scholar 

  16. Ochs N, Auer R, Bauer DC, et al. Meta-analysis: subclinical thyroid dysfunction and the risk for coronary heart disease and mortality. Ann Intern Med. 2008;148:832–45.

    PubMed  Google Scholar 

  17. Haentjens P, Van Meerhaeghe A, Poppe K, Velkeniers B. Subclinical thyroid dysfunction and mortality: an estimate of relative and absolute excess all-cause mortality based on time-to-event data from cohort studies. Eur J Endocrinol. 2008;159:329–41.

    CAS  PubMed  Google Scholar 

  18. Yang LB, Jiang DQ, Qi WB, et al. Subclinical hyperthyroidism and the risk of cardiovascular events and all-cause mortality: an updated meta-analysis of cohort studies. Eur J Endocrinol. 2012;167:75–84.

    CAS  PubMed  Google Scholar 

  19. Collet TH, Gussekloo J, Bauer DC et al for the Thyroid Studies Collaboration. Subclinical hyperthyroidism and the risk of coronary heart disease and mortality. Arch Intern Med. 2012;172:799–809.

    Google Scholar 

  20. Fazio S, Palmieri EA, Lombardi G, Biondi B. Effects of thyroid hormone on the cardiovascular system. Recent Prog Horm Res. 2004;59:31–50.

    CAS  PubMed  Google Scholar 

  21. Biondi B, Palmieri EA, Lombardi G, Fazio S. Effects of thyroid hormone on cardiac function: the relative importance of heart rate, loading conditions, and myocardial contractility in the regulation of cardiac performance in human hyperthyroidism. J Clin Endocrinol Metab. 2002;87:968–74.

    CAS  PubMed  Google Scholar 

  22. Kahaly GJ, Kampmann C, Mohr-Kahaly S. Cardiovascular hemodynamics and exercise tolerance in thyroid disease. Thyroid. 2002;12:473–81.

    PubMed  Google Scholar 

  23. Kahaly GJ, Nieswandt J, Wagner S, Schlegel J, Mohr-Kahaly S, Hommel G. Ineffective cardiorespiratory function in hyperthyroidism. J Clin Endocrinol Metab. 1998;83:4075–8.

    CAS  PubMed  Google Scholar 

  24. Engel AG. Neuromuscular manifestations of Graves’ disease. Mayo Clin Proc. 1972;47(12):919–25.

    CAS  PubMed  Google Scholar 

  25. Gold HK, Spann Jr JF, Braunwald E. Effects of alterations in the thyroid state on the intrinsic contractile properties of isolated rat skeletal muscle. J Clin Invest. 1970;49:849–54.

    PubMed Central  CAS  PubMed  Google Scholar 

  26. Lovejoy JC, Smith SR, Bray GA, et al. A paradigm of experimentally induced mild hyperthyroidism: effects on nitrogen balance, body composition, and energy expenditure in healthy young men. J Clin Endocrinol Metab. 1997;82:765–70.

    CAS  PubMed  Google Scholar 

  27. Fukui H, Taniguchi S, Ueta Y, et al. Enhanced activity of the purine nucleotide cycle of the exercising muscle in patients with hyperthyroidism. J Clin Endocrinol Metab. 2001;86:2205–10.

    CAS  PubMed  Google Scholar 

  28. Kaminski HJ, Ruff RL. Endocrine myopathies (hyper- and hypofunction of adrenal, thyroid, pituitary, and parathyroid glands and iatrogenic corticosteroid myopathy). In: Engel AG, Franzini-Armstrong C, editors. Myology. 2nd ed. New York, NY: McGraw-Hill; 1994. p. 1726–53.

    Google Scholar 

  29. Duyff RF, Van den Bosch J, Laman DM, van Loon BJ, Linssen WH. Neuromuscular findings in thyroid dysfunction: a prospective clinical and electrodiagnostic study. J Neurol Neurosurg Psychiatry. 2000;68:750–5.

    PubMed Central  CAS  PubMed  Google Scholar 

  30. Olson BR, Klein I, Benner R, Burdett R, Trzepacz P, Levey GS. Hyperthyroid myopathy and the response to treatment. Thyroid. 1991;1:137–1341.

    CAS  PubMed  Google Scholar 

  31. Bennett WR, Huston DP. Rhabdomyolysis in thyroid storm. Am J Med. 1984;77:733–5.

    CAS  PubMed  Google Scholar 

  32. Marinó M, Ricciardi R, Pinchera A, et al. Mild clinical expression of myasthenia gravis associated with autoimmune thyroid diseases. J Clin Endocrinol Metab. 1997;82:438–43.

    PubMed  Google Scholar 

  33. Kiessling WR, Finke R, Kotulla P, Schleusener H. Circulating TSH-binding inhibiting immunoglobulins in myasthenia gravis. Acta Endocrinol (Copenh). 1982;101:41–6.

    CAS  Google Scholar 

  34. Lin SH. Thyrotoxic periodic paralysis. Mayo Clin Proc. 2005;80:99–105.

    PubMed  Google Scholar 

  35. Ghose R, Quail G, King R, Moloney P. Hypokalemic paralysis in remote aboriginal communities. Aust Fam Physician. 1996;25:1172–3.

    CAS  PubMed  Google Scholar 

  36. Lin SH, Huang CL. Mechanism of thyrotoxic periodic paralysis. J Am Soc Nephrol. 2012;23:985–8.

    PubMed Central  CAS  PubMed  Google Scholar 

  37. Frost L, Vestergaard P, Mosekilde L. Hyperthyroidism and risk of atrial fibrillation flutter: a population-based study. Arch Intern Med. 2004;164:1675–8.

    PubMed  Google Scholar 

  38. Erem C. Blood coagulation, fibrinolytic activity and lipid profile in subclinical thyroid disease: subclinical hyperthyroidism increases plasma factor X activity. Clin Endocrinol (Oxf). 2006;64:323–9.

    CAS  Google Scholar 

  39. Sheu JJ, Kang JH, Lin HC, Lin HC. Hyperthyroidism and risk of ischemic stroke in young adults: a 5-year follow-up study. Stroke. 2010;41:961–6.

    PubMed  Google Scholar 

  40. Lin HC, Yang LY, Kang JH. Increased risk of pulmonary embolism among patients with hyperthyroidism: a 5-year follow-up study. J Thromb Haemost. 2010;8:2176–81.

    PubMed  Google Scholar 

  41. Squizzato A, Gerdes VE, Brandjes DP, Buller HR, Stam J. Thyroid diseases and cerebrovascular disease. Stroke. 2005;36:2302–10.

    CAS  PubMed  Google Scholar 

  42. Biondi B. Mechanisms in endocrinology: heart failure and thyroid dysfunction. Eur J Endocrinol. 2012;167:609–18.

    CAS  PubMed  Google Scholar 

  43. De Groot WJ, Leonard JJ. Hyperthyroidism as a high cardiac output state. Am Heart J. 1970;79:265–75.

    Google Scholar 

  44. Yu YH, Bilezikian JP. Tachycardia-induced cardiomyopathy secondary to thyrotoxicosis: a young man with previously unrecognized Graves’ disease. Thyroid. 2000;10:923–7.

    CAS  PubMed  Google Scholar 

  45. Cruz FE, Cheriex EC, Smeets JL, et al. Reversibility of tachycardia-induced cardiomyopathy after cure of incessant supraventricular tachycardia. J Am Coll Cardiol. 1990;16:739–44.

    CAS  PubMed  Google Scholar 

  46. Siu CW, Yeung CY, Lau CP, Kung AW, Tse HF. Incidence, clinical characteristics and outcome of congestive heart failure as the initial presentation in patients with primary hyperthyroidism. Heart. 2007;93:483–7.

    PubMed Central  PubMed  Google Scholar 

  47. Anakwue RC, Onwubere BJ, Anisiuba BC, Ikeh VO, Mbah A, Ike SO. Congestive heart failure in subjects with thyrotoxicosis in a black community. Vasc Health Risk Manag. 2010;6:473–7.

    PubMed Central  CAS  PubMed  Google Scholar 

  48. Yue WS, Chong BH, Zhang XH, et al. Hyperthyroidism-induced left ventricular diastolic dysfunction: implication in hyperthyroidism-related heart failure. Clin Endocrinol (Oxf). 2011;74:636–43.

    Google Scholar 

  49. Cavros NG, Old WD, Castro FD, Estep HL. Case report: reversible mitral regurgitation and congestive heart failure complicating thyrotoxicosis. Am J Med Sci. 1996;311:142–4.

    CAS  PubMed  Google Scholar 

  50. Kage K, Kira Y, Sekine I, et al. High incidence of mitral and tricuspid regurgitation in patients with Graves’ disease detected by two-dimensional color Doppler echocardiography. Intern Med. 1993;32:374–6.

    CAS  PubMed  Google Scholar 

  51. Kahaly G. Graves’ disease and mitral valve prolapse. JAMA. 1987;257:252.

    Google Scholar 

  52. Kahaly GJ, Mohr-Kahaly S, Beyer J, Meyer J. Prevalence of myxomatous mitral valve prolapse in patients with lymphocytic thyroiditis. Am J Cardiol. 1995;76:1309–10.

    CAS  PubMed  Google Scholar 

  53. Khoo DH, Parma J, Rajasoorya C, Ho SC, Vassart G. A germline mutation of the thyrotropin receptor gene associated with thyrotoxicosis and mitral valve prolapse in a Chinese family. J Clin Endocrinol Metab. 1999;84:1459–62.

    CAS  PubMed  Google Scholar 

  54. Siu CW, Zhang XH, Yung C, Kung AW, Lau CP, Tse HF. Hemodynamic amic changes in hyperthyroidism-related pulmonary hypertension: a prospective echocardiographic study. J Clin Endocrinol Metab. 2007;2:1736–42.

    Google Scholar 

  55. Li JH, Safford RE, Aduen JF, Heckman MG, Crook JE, Burger CD. Pulmonary hypertension and thyroid disease. Chest. 2007;132:793–7.

    PubMed  Google Scholar 

  56. Marvisi M, Brianti M, Marani G, Del Borello R, Bortesi ML, Guariglia A. Hyperthyroidism and pulmonary hypertension. Respir Med. 2002;96:215–20.

    CAS  PubMed  Google Scholar 

  57. Armigliato M, Paolini R, Aggio S, et al. Hyperthyroidism as a cause of pulmonary arterial hypertension: a prospective study. Angiology. 2006;57:600–6.

    PubMed  Google Scholar 

  58. Nakchbandi IA, Wirth JA, Inzucchi SE. Pulmonary hypertension caused by Graves’ thyrotoxicosis. Chest. 1999;116:1483–5.

    CAS  PubMed  Google Scholar 

  59. Merce J. Cardiovascular abnormalities in hyperthyroidism: a prospective Doppler echocardiographic study. Am J Med. 2005;118:126–31.

    PubMed  Google Scholar 

  60. Chu JW, Kao PN, Faul JL, Doyle RL. High prevalence of autoimmune thyroid disease in pulmonary arterial hypertension. Chest. 2002;122:1668–73.

    PubMed  Google Scholar 

  61. Ma RC, Cheng AY, So WY, Hui DS, Tong PC, Chow CC. Thyrotoxicosis and pulmonary hypertension. Am J Med. 2005;118:927–8.

    PubMed  Google Scholar 

  62. Badesch DB, Wynne KM, Bonvallet S, Voelkel NF, Ridgway C, Groves BM. Hypothyroidism and primary pulmonary hypertension: an autoimmune pathogenetic link. Ann Intern Med. 1993;119:44–6.

    CAS  PubMed  Google Scholar 

  63. Lozano HF, Sharma CN. Reversible pulmonary hypertension, tricuspid regurgitation and right-sided heart failure associated with hyperthyroidism: case report and review of the literature. Cardiol Rev. 2004;12:299–305.

    PubMed  Google Scholar 

  64. Ismail HM. Reversible pulmonary hypertension and isolated right-sided heart failure associated with hyperthyroidism. J Gen Intern Med. 2007;22:148–50.

    PubMed Central  PubMed  Google Scholar 

  65. Berlin T, Lubina A, Levy Y, Shoenfeld Y. Graves’ disease presenting as right heart failure. Isr Med Assoc J. 2008;8:217–8.

    Google Scholar 

  66. Cohen J, Shattner A. Right heart failure and hyperthyroidism: a neglected presentation. Am J Med. 2003;11:576–7.

    Google Scholar 

  67. Shirani J, Barron MM, Pierre-Louis ML, Roberts WC. Congestive heart failure, dilated cardiac ventricles, and sudden death in hyperthyroidism. Am J Cardiol. 1993;72:365–8.

    CAS  PubMed  Google Scholar 

  68. Fatourechi V, Edwards WD. Graves’ disease and low-output cardiac dysfunction: implications for autoimmune disease in endomyocardial biopsy tissue from eleven patients. Thyroid. 2000;10:601–5.

    CAS  PubMed  Google Scholar 

  69. Boccaladro C, Boccalandro F, Orlander P, Wei CF. Severe reversible dilated cardiomyopathy and hyperthyroidism: case report and review of the literature. Endocr Pract. 2003;9:140–6.

    Google Scholar 

  70. Londhey VA, Kamble US, Limaye CS, Pednekar SJ, Kini SH, Borges NE. Irreversible dilated cardiomyopathy due to thyrotoxicosis. J Assoc Physicians India. 2006;54:575–6.

    CAS  PubMed  Google Scholar 

  71. Ebisawa K, Ikeda U, Murata M, et al. Irreversible cardiomyopathy due to thyrotoxicosis. Cardiology. 1994;84:274–7.

    CAS  PubMed  Google Scholar 

  72. Al-Ghamdi AS, Aljohani N. Graves’ thyrotoxicosis-induced reversible cardiomyopathy: a case report. Clin Med Insights Case Rep. 2013;27:47–50.

    Google Scholar 

  73. Eliades M, El-Maouche D, Choudhary C, Zinsmeister B, Burman KD. Takotsubo cardiomyopathy associated with thyrotoxicosis: a case report and review of the literature. Thyroid. 2014;24:383–9.

    PubMed Central  PubMed  Google Scholar 

  74. Sliwa K, Skudicky D, Bergemann A, Candy G, Puren A, Sareli P. Peripartum cardiomyopathy: analysis of clinical outcome, left ventricular function, plasma levels of cytokines and Fas/APO-1. J Am Coll Cardiol. 2000;35:701–5.

    CAS  PubMed  Google Scholar 

  75. Gleicher N, Elkayam U. Peripartum cardiomyopathy, an autoimmune manifestation of allograft rejection? Autoimmun Rev. 2009;8:384–7.

    CAS  PubMed  Google Scholar 

  76. Valko PC, Carty DL. Peripartum cardiac failure in a woman with Graves’ disease. Am J Emerg Med. 1992;10:46–9.

    CAS  PubMed  Google Scholar 

  77. Gentry MB, Dias JK, Luis A, Patel R, Thornton J, Reed GL. African-American women have a higher risk for developing peripartum cardiomyopathy. J Am Coll Cardiol. 2010;55:654–9.

    PubMed  Google Scholar 

  78. Nabriski D, Ellis M, Ness-Abramof R, Shapiro M, Shenkman L. Autoimmune thyroid disease and antiphospholipid antibodies. Am J Hematol. 2000;64:73–5.

    CAS  PubMed  Google Scholar 

  79. Khochtali I, Hamza N, Gassab E, et al. Graves’ disease associated with cerebrovascular disease and antiphospholipid antibody syndrome. Int J Endocrinol. 2010;2010:1–3.

    Google Scholar 

  80. Mayaudon H, Crozes P, Riveline JP, Boyer B, Simon P, Bauduceau B. Antiphospholipid antibodies in Basedow disease. Presse Med. 1994;23:1496.

    CAS  PubMed  Google Scholar 

  81. Mouelhi L, Chaieb M, Debbeche R, et al. Association Budd Chiari syndrome, antiphospholipid syndrome and graves’ disease. Tunis Med. 2009;87:164–6.

    PubMed  Google Scholar 

  82. Hofbauer LC, Spitzweg C, Heufelder AE. Graves’ disease associated with the primary antiphospholipid syndrome. J Rheumatol. 1996;23:1435–7.

    CAS  PubMed  Google Scholar 

  83. Jain A. Antiphospholipid antibody syndrome associated with graves’ disease presenting as inferior vena cava thrombosis with bilateral lower limb DVT. Clin Med Insights Case Rep. 2014;16:37–9.

    Google Scholar 

  84. Völzke H, Schwahn C, Wallaschofski H, Dörr M. Review: the association of thyroid dysfunction with all-cause and circulatory mortality: is there a causal relationship? J Clin Endocrinol Metab. 2007;92:2421–9.

    PubMed  Google Scholar 

  85. Brand F, Green A, Hegedüs L, Brix TH. A critical review and meta-analysis of the association between overt hyperthyroidism and mortality. Eur J Endocrinol. 2011;165:491–7.

    Google Scholar 

  86. Brandt F, Thvilum M, Almind D, et al. Graves’ disease and toxic nodular goiter are both associated with increased mortality but differ with respect to the cause of death: a Danish population-based register study. Thyroid. 2013;23:408–13.

    PubMed  Google Scholar 

  87. Brandt F, Almind D, Christensen K, Green A, Brix TH, Hegedüs L. Excess mortality in hyperthyroidism: the influence of preexisting comorbidity and genetic confounding: a Danish nationwide register-based cohort study of twins and singletons. J Clin Endocrinol Metab. 2012;97:4123–9.

    PubMed Central  CAS  PubMed  Google Scholar 

  88. Brandt F, Thvilum M, Almind D, et al. Morbidity before and after the diagnosis of hyperthyroidism: a nationwide register-based study. PLoS One. 2013;20(8):e66711.

    Google Scholar 

  89. Boelaert K, Maisonneuve P, Torlinska B, Franklyn JA. Comparison of mortality in hyperthyroidism during periods of treatment with thionamides and after radioiodine. J Clin Endocrinol Metab. 2013;98:1869–82.

    CAS  PubMed  Google Scholar 

  90. Ryödi E, Salmi J, Jaatinen P, et al. Cardiovascular morbidity and mortality in surgically treated hyperthyroidism—a nation-wide cohort study with a long-term follow-up. Clin Endocrinol (oXF). 2014;80:743–50.

    Google Scholar 

  91. Metso S, Jaatinen P, Huhtala H, Auvinen A, Oksala H, Salmi J. Increased cardiovascular and cancer mortality after radioiodine treatment for hyperthyroidism. J Clin Endocrinol Metab. 2007;92:2190–6.

    CAS  PubMed  Google Scholar 

  92. Nyrienda MJ, Clark DN, Finlaysa AR, et al. Thyroid disease and increased cardiovascular risk. Thyroid. 2005;15:718–24.

    Google Scholar 

  93. Biondi B, Palmieri EA, Fazio S, et al. Endogenous subclinical hyperthyroidism affects quality of life and cardiac morphology and function in young and middle-aged patients. J Clin Endocrinol Metab. 2003;85:4701–5.

    Google Scholar 

  94. Biondi B, Palmieri EA, Lombardi G, Fazio S. Effects of subclinical thyroid dysfunction on the heart. Ann Intern Med. 2002;137:904–14.

    PubMed  Google Scholar 

  95. Biondi B, Cooper DS. The clinical significance of subclinical thyroid dysfunction. Endocr Rev. 2008;29:76–131.

    CAS  PubMed  Google Scholar 

  96. Cooper DS, Biondi B. Subclinical thyroid disease. Lancet. 2012;379:1142–54.

    PubMed  Google Scholar 

  97. Sawin CT, Geller A, Wolf PA, et al. Low serum thyrotropin concentrations as a risk factor for atrial fibrillation in older persons. N Engl J Med. 1994;331:1249–52.

    CAS  PubMed  Google Scholar 

  98. Cappola AR, Fried LP, Arnold AM, et al. Thyroid status, cardiovascular risk, and mortality in older adults. JAMA. 2006;295:1033–41.

    PubMed Central  CAS  PubMed  Google Scholar 

  99. Gencer B, Collet TH, Virgini v, et al. Thyroid Studies Collaboration. Subclinical thyroid dysfunction and the risk of heart failure events: an individual participant data analysis from six prospective cohorts. Circulation. 2012;126:1040–9.

    CAS  PubMed  Google Scholar 

  100. Bahn RS, Burch HB, Cooper DS, et al. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid. 2011;21:593–646.

    Google Scholar 

  101. Osman F, Franklyn J, Holder RL, Sheppard MC, Gammage MD. Cardiovascular manifestations of hyperthyroidism before and after antithyroid therapy: a matched case–control study. J Am Coll Cardiol. 2007;49:71–81.

    CAS  PubMed  Google Scholar 

  102. Biondi B. How could we improve the increased cardiovascular mortality in patients with overt and subclinical hyperthyroidism? Eur J Endocrinol. 2012;167:295–9.

    CAS  PubMed  Google Scholar 

  103. Sundaresh V, Brito JP, Wang Z, et al. Comparative effectiveness of therapies for Graves’ hyperthyroidism: a systematic review and network meta-analysis. J Clin Endocrinol Metab. 2013;98:3671–7.

    PubMed Central  CAS  PubMed  Google Scholar 

  104. Bahn RS. Is radioiodine more likely than antithyroid drugs to worsen ophthalmopathy in patients with Graves disease? Nat Clin Pract Endocrinol Metab. 2008;4:594–5.

    PubMed Central  CAS  PubMed  Google Scholar 

  105. Nakazawa K, Sakurai K, Hamada N, Momotani N, Ito K. Management of atrial fibrillation in the post-thyrotoxic state. Am J Med. 1982;72:903–6.

    CAS  PubMed  Google Scholar 

  106. Shimizu T, Koide S, Noh JY, Sugino K, Ito K, Nakazawa H. Hyperthyroidism and the management of atrial fibrillation. Thyroid. 2002;12:489–93.

    PubMed  Google Scholar 

  107. Anderson JL, Halperin JL, Albert NM. Management of patients with atrial fibrillation (compilation of 2006 ACCF/AHA/ESC and 2011 ACCF/AHA/HRS recommendations): a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;61:1935–44.

    PubMed  Google Scholar 

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Biondi, B. (2015). Impact of Hyperthyroidism on the Cardiovascular and Musculoskeletal Systems and Management of Patients with Subclinical Graves’ Disease. In: Bahn, R. (eds) Graves' Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2534-6_10

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