CARDIOVASCULAR MANIFESTATIONS IN PATIENTS WITH THYROID DYSFUNCTION

Purpose of the trial :- To study various cardiovascular manifestations in patients with thyroid dysfunction.

Objectives:

PRIMARY OBJECTIVES:

•       To study the prevalence of cardiovascular manifestations in patients of thyroid dysfunction

•       To study the effect of treatment on the cardiovascular manifestations in these patients

SECONDARY OBJECTIVES:

•       To study the effect of treatment on metabolic profile in patients with thyroid disorders

•       To study the effect of treatment on NT Pro BNP levels in patients with thyroid disorders

Some major findings and references:

1. In a study conducted by M.Schultz et al,  NT-pro-BNP levels were more than four times higher in hyperthyroid than hypothyroid patients, with mean values of 30 and 7 pmol/l, respectively ( P < 0·001). Serum NT-pro-BNP levels correlated to the thyroid function ( vs. free T4 estimate: r = 0·52, P < 0·0001, n = 57). Treatment resulted in significant increases in NT-pro- BNP in both hypothyroid groups, and decreases in both hyperthyroid groups.

2. Regarding hyperthyroidism, in one study conducted by Hailu Abera Mulatu, Echocardiographic abnormalities were detected in half (50.7%) of the patients. The study showed that (18.5%) patients had heart failure at initial presentation with the most common cardiovascular manifestations being exertional dyspnea (54.8%), pitting edema (18.5%) and elevated jugular venous pressure (15.8%). Nearly half (48.6%) of the patients had hypertension, and atrial fibrillation was seen in 11% of patients.(4.1%) patients had heart failure with reduced ejection fraction while another (4.1%) patients had isolated right sided heart failure. Pulmonary hypertension with pulmonary artery systolic pressure of 35 mmHg or more was found in (37%) patients.

3. Regarding hypothyroidism, in a study by Preshant Shrivastava, more than 65% subjects were found to have clinically significant cardiovascular changes. ECG changes observed were Sinus bradycardia in 35.5%, Low voltage complexes in 16.6%, T Wave inversion in 7.8%, RBBB in 4.4%, and QTc prolongation in 2.2% cases. About 64% cases had changes as observed in echocardiographic examination. Most common finding was Diastolic dysfunction seen in 20% cases. This was followed by Pericardial Effusion and Increased IVSD thickness in 16.6% cases each. Increased LVPW thickness was seen in 11.1% cases.