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Control of breathing in patients with short-term primary hypothyroidism

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Abstract

In 8 patients (3 men and 5 women) with short-term primary hypothyroidism before and during replacement therapy, and in an age-matched control group (9 men and 7 women), we assessed maximal inspiratory muscle force (Pimax) and the ventilatory control system at neural (EMG), muscular (P0.1), and ventilatory (VE and Vt/Ti) levels. While hypothyroid, patients exhibited a significantly lower Pimax. During a CO2 rebreathing test, hypothyroid patients exhibited similar diaphragmatic electromyographic (EMGd) and ventilatory (VE) response slopes to increasing end-tidal CO2 tension (ΔEMGd/ΔPetCO2 and ΔVE/ΔPetCO2), but significantly less ΔP0.1/ΔPetCO2 (p<0.05) and Δ(Vt/Ti)/ΔPetCO2 (p<0.05) response slopes. During replacement therapy with L-triiodothyronine (L-T3), Pimax (p<0.05), ΔP0.1/ΔPetCO2, and Δ(Vt/Ti)/ΔPetCO2 response slopes were found to be significantly increased (p<0.05 for both) while neither EMGd nor VE response changed significantly. We concluded that short-term hypothyroidism does not seem to be associated with blunted neural inspiratory output (EMGd), the respiratory control system seems to be affected mostly at a peripheral (muscular) level, and L-T3 increases both force (P0.1 and Pimax) and velocity (Vt/Ti) of inspiratory muscle contraction.

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Authors and Affiliations

  1. Istituto di Clinica Medica III, Universita’ degli Studi, Via le G.B. Morgagni 85, 50134, Firenze, Italy

    M. Gorini, A. Spinelli, C. Cangioli, F. Gigliotti, R. Duranti, P. Arcangeli & G. Scano

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  1. M. Gorini
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  2. A. Spinelli
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  3. C. Cangioli
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  4. F. Gigliotti
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  5. R. Duranti
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  6. P. Arcangeli
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  7. G. Scano
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Gorini, M., Spinelli, A., Cangioli, C. et al. Control of breathing in patients with short-term primary hypothyroidism. Lung 167, 43–53 (1989). https://doi.org/10.1007/BF02714929

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