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World Journal of Surgery

, Volume 42, Issue 5, pp 1408–1414 | Cite as

A Prospective Comparative Study on Improvement of Hyperthyroid Cardiovascular Dysfunction in Patients Undergoing Total Thyroidectomy Versus Medical Management

  • S. Muthukumar
  • K. Ravikumar
  • S. Dhalapathy
  • T. Gomathy
  • S. Umadevi
  • D. Maruthupandian
Original Scientific Report

Abstract

Introduction

Cardiovascular dysfunction (CVD) is a well-recognized complication in patients with hyperthyroidism and is the major cause of mortality. Very few studies have compared the outcome of CVD following different treatment modalities. In this study we intended to compare treatment modalities (antithyroid drugs vs surgery) for reversal of CVD.

Materials and methods

Patients with newly detected hyperthyroidism were grouped into, Group I [n = 123, age <60 years, undergoing total thyroidectomy], Group II [n = 42, age <60 years, treated with antithyroid medications] were evaluated with 2D echocardiography, serum N terminal pro brain natriuretic peptide (NT-pro-BNP) at the time of diagnosis (Point A), after achieving euthyroidism (Point B) with antithyroid drugs and 6 months after surgery/continuation of antithyroid medications (Point C). Forty patients (Group III), age < 60 years, undergoing total thyroidectomy for nontoxic benign thyroid nodules served as controls.

Results

All groups were age and sex matched. At Point A, CVD was evident in 80/123 (65%) in Group I and 28/42 (66.7%) in Group II. At Point B improvement in CVD occurred in 84/123 (68.3%) in Group and 29/42 (69.04%) in Group II. At Point C dramatic improvement in CVD occurred in 118/123 (95.9%) in Group I, whereas only 33/42 (78.5%) improved in Group II. CVD were comparable between Groups I and II at Point A and Point B (p > 0.05). At Point C there was a significant decrease in all the diastolic dysfunction parameters in Group I, whereas the same was not observed in Group II patients. Systolic dysfunction between Groups II and II had no statistical significance at Point C.

Conclusion

Total thyroidectomy seems to be the definitive treatment of choice for hyperthyroid cardiac dysfunction with diastolic dysfunction completely reversing at 6 months after TT.

Notes

Acknowledgements

We are indebted to Dr. Srinivasa Raman, MD, Anderson Diagnostics and laboratories, Chennai, for his excellent laboratory services without whom we would not have completed this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • S. Muthukumar
    • 1
    • 2
  • K. Ravikumar
    • 2
    • 3
  • S. Dhalapathy
    • 2
    • 4
  • T. Gomathy
    • 5
    • 6
  • S. Umadevi
    • 2
  • D. Maruthupandian
    • 1
  1. 1.Department of Endocrine SurgeryMadurai Medical CollegeMaduraiIndia
  2. 2.Department of Endocrine SurgeryMadras Medical CollegeChennaiIndia
  3. 3.Department of Endocrine SurgeryChristian Medical CollegeVelloreIndia
  4. 4.Department of Endocrine and Speciality ClinicEndocrine SurgeryChennaiIndia
  5. 5.Department of CardiologyMadras Medical CollegeChennaiIndia
  6. 6.Department of CardiologyThanjavur Medical CollegeThanjavurIndia

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