Myocardial damage does not occur in untreated hyperthyroidism unless associated with congestive heart failure

American Heart Journal
V MartíS M Webb

Abstract

Even in the absence of underlying cardiac disease, hyperthyroidism has seldom been reported to be associated with left ventricular dysfunction and congestive heart failure. The left ventricular function invariably improves with achievement of euthyroid status. Anecdotal autopsy reports have suggested that myocardial necrosis associated with hyperthyroidism may be responsible for congestive heart failure. This study prospectively evaluates the role of myocardial necrosis in untreated hyperthyroidism by imaging with Indium-111 antimyosin antibody. Thirteen consecutive patients (7 men and 6 women, mean age 36 +/- 11 years) with hyperthyroidism and Graves' disease (10 patients), subacute thyroiditis (2 patients), or multinodular goiter (1 patient) formed the basis of the study. The T4 levels ranged from 33 to 183 pmol/L (mean 103 +/- 47 pmol/L) and cardiac output from 5.47 to 11.0 L/min (mean 7.17 +/- 1.75 L/min). Two patients had clinical congestive heart failure and mildly depressed left ventricular ejection fraction. Both patients had scintigraphic evidence of myocardial damage with abnormal antimyosin scans. In the remaining 11 patients with normal left ventricular ejection fraction, no antimyosin uptake was observed. The reeva...Continue Reading

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Citations

Mar 15, 2003·European Journal of Nuclear Medicine and Molecular Imaging·Albert Flotats, Ignasi Carrió
Feb 8, 2005·The American Journal of Medicine·Jordi MercéCristóbal Ridao
Aug 15, 2003·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Cristina BoccalandroChik Fong Wei
Jan 23, 2008·Arquivos brasileiros de endocrinologia e metabologia·Luiz Eduardo A WildembergMarcus V Leitão de Souza

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