Abstract
Hyperthyroidism causes a variety of adverse effects on the cardiovascular system. Left ventricular (LV) asynchrony is defined as loss of the simultaneous peak contraction of corresponding cardiac segments. The aim of this study was to assess systolic asynchrony in patients with overt hyperthyroidism. Asynchrony was evaluated in 27 patients with overt hyperthyroidism and 21 controls. All the patients and controls were subjected to a tissue synchronization imaging (TSI). The time to regional peak systolic tissue velocity (Ts) in LV by the six-basal-six-mid-segmental model was measured on ejection phase TSI images and four TSI parameters of systolic asynchrony were computed. All TSI parameters of LV asynchrony increased in hyperthyroid patients compared to controls: the standard deviation (SD) of the 12 LV segments Ts (35.7 ± 14.4 vs 20.1 ± 10.1, P < 0.0001); the maximal difference in Ts between any 2 of the 12 LV segments (111.9 ± 40.7 vs 65.9 ± 30.7, P < 0.0001); the SD of the 6 basal LV segments (31.2 ± 18.2 vs 16.8 ± 9.7, P = 0.01); and the maximal difference in Ts between any 2 of the 6 basal LV segments (76.6 ± 42.0 vs 44.4 ± 25.7, P = 0.005). Patients with overt hyperthyroidism present evidence of LV asynchrony by TSI.
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References
I. Klein, Endocrine disorders and cardiovascular disease, in Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine, 7th edn., ed. by E. Braunwald (Elsevier Saunders, Philadelphia, 2005), pp. 2056–2063
I. Klein, S. Danzi, Thyroid disease and the heart. Circulation 116(15), 1725–1735 (2007)
Y.H. Choi, J.H. Chung, S.W. Bae, W.H. Lee, E.M. Jeong, M.G. Kang, B.J. Kim, K.W. Kim, J.E. Park, Severe coronary artery spasm can be associated with hyperthyroidism. Coron. Artery Dis. 16, 135–139 (2005)
A.D. Toft, N.A. Boon, Thyroid disease and the heart. Heart 84(4), 455–460 (2000)
A. Shefer, Y. Rozenman, Y. Ben David, M.Y. Flugelman, M.S. Gotsman, B.S. Lewis, Left ventricular function during physiological cardiac pacing: relation to rate, pacing mode, and underlying myocardial disease. Pacing Clin. Electrophysiol. 10, 315–325 (1987)
T.A. Buckingham, Right ventricular outflow tract pacing. Pacing Clin. Electrophysiol. 20, 1237–1242 (1997)
T.M. Kolettis, Z.S. Kyriakides, D. Tsiapras, T. Popov, I.A. Paraskevaides, D.T. Kremastinos, Improved left ventricular relaxation during short-term right ventricular outflow tract compared to apical pacing. Chest 117, 60–64 (2000)
C. Alonso, C. Leclercq, F. Victor, H. Mansour, C. de Place, D. Pavin, F. Carré, P. Mabo, J.C. Daubert, Electrocardiographic predictive factors of long-term clinical improvement with multisite biventricular pacing in advanced heart failure. Am. J. Cardiol. 84, 1417–1421 (1999)
G.S. Nelson, C.W. Curry, B.T. Wyman, A. Kramer, J. Declerck, M. Talbot, M.R. Douglas, R.D. Berger, E.R. McVeigh, D.A. Kass, Predictors of systolic augmentation from left ventricular pre-excitation in patients with dilated cardiomyopathy and intraventricular conduction delay. Circulation 101, 2703–2709 (2000)
C.M. Yu, W.H. Fung, H. Lin, Q. Zhang, J.E. Sanderson, C.P. Lau, Predictors of left ventricular reverse remodelling after cardiac resynchronization therapy for heart failure secondary to idiopathic dilated or ischemic cardiomyopathy. Am. J. Cardiol. 91, 684–688 (2003)
J.J. Bax, G.B. Bleeker, T.H. Marwick, S.G. Molhoek, E. Boersma, P. Steendijk, E.E. van der Wall, M.J. Schalij, Left ventricular dyssynchrony predicts response and prognosis after cardiac resynchronization therapy. J. Am. Coll. Cardiol. 44, 834–840 (2004)
Y. Zhang, A.K. Chan, C.M. Yu, W.W. Lam, G.W. Yip, W.H. Fung, N.M. So, M. Wang, J.E. Sanderson, Left ventricular systolic asynchrony after acute myocardial infarction in patients with narrow QRS complexes. Am. Heart J. 149, 497–503 (2005)
G. Korosoglou, P.M. Humpert, E. Halbgewachs, R. Bekeredjian, A. Filusch, S.J. Buss, M. Morcos, A. Bierhaus, H.A. Katus, P.P. Nawroth, H. Kuecherer, Evidence of left ventricular contractile asynchrony by echocardiographic phase imaging in patients with type 2 diabetes mellitus and without clinically evident heart disease. Am. J. Cardiol. 98, 1525–1530 (2006)
C.-M. Yu, Q. Zhang, G.W.K. Yip, P.-W. Lee, L.C.C. Kum, Y.-Y. Lam, J.W.-H. Fung, Diastolic and systolic asynchrony in patients with diastolic heart failure: a common but ignored condition. J. Am. Coll. Cardiol. 49, 97–105 (2007)
R. Marfella, K. Esposito, M. Siniscalchi, F. Cacciapuoti, F. Giugliano, D. Labriola, M. Ciotola, C. Di Palo, L. Misso, D. Giugliano, Effect of weight loss on cardiac synchronization and proinflammatory cytokines in premenopausal obese women. Diabetes Care 27, 47–52 (2004)
N.B. Schiller, P.M. Shah, M. Crawford, A. DeMaria, R. Devereux, H. Feigenbaum, H. Gutgesell, N. Reichek, D. Sahn, I. Schnittger et al., Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. J. Am. Soc. Echocardiogr. 2, 358–367 (1989)
C. Shub, A.L. Klein, P.K. Zachariah, K.R. Bailey, A.J. Tajik, Determination of left ventricular mass by echocardiography in a normal population: effect of age and sex in addition to body size. Mayo Clin. Proc. 69, 205–211 (1994)
C.M. Yu, Q. Zhang, J.W. Fung, H.C. Chan, Y.S. Chan, G.W. Yip, S.L. Kong, H. Lin, Y. Zhang, J.E. Sanderson, A novel tool to assess systolic asynchrony and identify responders of cardiac resynchronization therapy by tissue synchronization imaging. J. Am. Coll. Cardiol. 45, 677–684 (2005)
C.M. Yu, H. Lin, Q. Zhang, J.E. Sanderson, High prevalence of left ventricular systolic and diastolic asynchrony in patients with congestive heart failure and normal QRS duration. Heart 89, 54–60 (2003)
C.M. Yu, J.W. Fung, Q. Zhang, C.K. Chan, Y.S. Chan, H. Lin, L.C. Kum, S.L. Kong, Y. Zhang, J.E. Sanderson, Tissue Doppler imaging is superior to strain rate imaging and postsystolic shortening on the prediction of reverse remodelling in both ischemic and nonischemic heart failure after cardiac resynchronization therapy. Circulation 110, 66–73 (2004)
J.W. Smit, C.F. Eustatia-Rutten, E.P. Corssmit, A.M. Pereira, M. Frölich, G.B. Bleeker, E.R. Holman, E.E. van der Wall, J.A. Romijn, J.J. Bax, Reversible diastolic dysfunction after long-term exogenous subclinical hyperthyroidism: a randomized, placebo-controlled study. J. Clin. Endocrinol. Metab. 90(11), 6041–6047 (2005)
G. Bodlaj, R. Pichler, W. Brandstätter, M. Hatzl-Griesenhofer, W. Maschek, G. Biesenbach, J. Berg, Hyperthyroidism affects arterial stiffness, plasma NT-pro-B-type natriuretic peptide levels, and subendocardial perfusion in patients with Graves’ disease. Ann. Med. 39(8), 608–616 (2007)
I. Klein, C. Hong, Effects of thyroid hormone on cardiac size and myosin content of the heterotopically transplanted rat heart. J. Clin. Invest. 77, 1694–1698 (1986)
B. Biondi, E.A. Palmieri, S. Fazio, C. Cosco, M. Nocera, L. Sacca, S. Filetti, G. Lombardi, F. Perticone, Endogenous subclinical hyperthyroidism affects quality of life and cardiac morphology and function in young and middle-aged patients. J. Clin. Endocrinol. Metab. 85, 4701–4705 (2000)
M. Dorr, B. Wolff, D.M. Robinson, U. John, J. Ludemann, W. Meng, S.B. Felix, H. Volzke, The association of thyroid function with cardiac mass and left ventricular hypertrophy. J. Clin. Endocrinol. Metab. 90, 673–677 (2005)
U. Guntekin, Y. Gunes, M. Tuncer, H. Simsek, H.A. Gumrukcuoglu, S. Arslan, A. Gunes, QTc dispersion in hyperthyroidism and its association with pulmonary hypertension. Pacing Clin. Electrophysiol. 32(4), 494–499 (2009)
M. Donatelli, P. Assennato, V. Abbadi, M.L. Bucalo, V. Compagno, S. Lo Vecchio, L. Messina, V. Russo, A. Schembri, V. Torregrossa, G. Licata, Cardiac changes in subclinical and overt hyperthyroid women: retrospective study. Int. J. Cardiol. 90(2–3), 159–164 (2003)
V. Di Bello, F. Aghini-Lombardi, F. Monzani, E. Talini, L. Antonangeli, C. Palagi, A. Di Cori, N. Caraccio, M.G. Delle Donne, A. Dardano, A. Pinchera, M. Mariani, Early abnormalities of left ventricular myocardial characteristics associated with subclinical hyperthyroidism. J. Endocrinol. Invest. 30(7), 564–571 (2007)
J. Mercé, S. Ferrás, C. Oltra, E. Sanz, J. Vendrell, I. Simón, M. Camprubí, A. Bardají, C. Ridao, Cardiovascular abnormalities in hyperthyroidism: a prospective Doppler echocardiographic study. Am. J. Med. 118(2), 126–131 (2005)
S. Levick, A. Fenning, L. Brown, Increased calcium influx mediates increased cardiac stiffness in hyperthyroid rats. Cell Biochem. Biophys. 43(1), 53–60 (2005)
H.W. Tan, G.L. Zheng, L. Li, Z.H. Wang, H.P. Gong, Y. Zhang, M. Zhong, W. Zhang, Impaired left ventricular synchronicity in hypertensive patients with ventricular hypertrophy. J. Hypertens. 26(3), 553–559 (2008)
W. Kosmala, W. Kucharski, M. Przewlocka-Kosmala, W. Mazurek, Comparison of left ventricular function by tissue Doppler imaging in patients with diabetes mellitus without systemic hypertension versus diabetes mellitus with systemic hypertension. Am. J. Cardiol. 94, 395–399 (2004)
Z.S. Kyriakides, A.G. Manolis, T.M. Kolettis, The effects of ventricular asynchrony on myocardial perfusion. Int. J. Cardiol. 119(1), 3–9 (2007)
E.G. DePuey, E. Guertler-Krawczynska, W.L. Robbins, Thallium-201 SPECT in coronary artery disease patients with left bundle branch block. J. Nucl. Med. 29(9), 1479–1485 (1988)
R. Lieberman, L. Padeletti, J. Schreuder, K. Jackson, A. Michelucci, A. Colella, W. Eastman, S. Valsecchi, D.A. Hettrick, Ventricular pacing lead location alters systemic hemodynamics and left ventricular function in patients with and without reduced ejection fraction. J. Am. Coll. Cardiol. 48, 1634–1641 (2006)
K. Vernooy, X.A. Verbeek, M. Peschar, H.J. Crijns, T. Arts, R.N. Cornelussen, F.W. Prinzen, Left bundle branch block induces ventricular remodelling and functional septal hypoperfusion. Eur. Heart J. 26(1), 91–98 (2005)
S. Kaplan, A. Kırış, C. Erem, T. Kaplan, G. Kırış, O. Gedikli, M. Koçak, M. Baykan, S. Celik, Assessment of left ventricular systolic asynchrony in patients with clinical hypothyroidism. Echocardiography 27(2), 117–122 (2010)
G.J. Kahaly, W.H. Dillmann, Thyroid hormone action in the heart. Endocr. Rev. 26(5), 704–728 (2005)
A.G. Dagre, J.P. Lekakis, T.G. Papaioannou, C.M. Papamichael, D.A. Koutras, S.F. Stamatelopoulos, M. Alevizaki, Arterial stiffness is increased in subjects with hypothyroidism. Int. J. Cardiol. 103(1), 1–6 (2005)
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Kırış, A., Erem, C., Kırış, G. et al. Intra-left ventricular systolic asynchrony in patients with overt hyperthyroidism. Endocr 38, 283–288 (2010). https://doi.org/10.1007/s12020-010-9385-6
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DOI: https://doi.org/10.1007/s12020-010-9385-6