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KMID : 1202020090020010022
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Journal of Korean Thyroid Association
2009 Volume.2 No. 1 p.22 ~ p.27
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The Change of Cardiovascular Parameters in Different Thyroid Function States in Patients with Differentiated Thyroid Cancer
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Kim Kyung-Won
Park Young-Joo
Chang Hyuk-Jae
Lee Eun-Jung
Lee Eun-Kyung
Choi Sung-Hee
Lim Soo
Park Do-Joon
Jang Hak-Chul
Cho Bo-Youn
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Abstract
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Background and Objectives: Some patients with differentiated thyroid cancer experience short-term hypothyroidism in preparation for radioiodine (RAI) therapy. It is not clear whether short-term hypothyroidism induces clinically significant cardiac dysfunction. In this study, we evaluated the changes of cardiac function and B-type natriuretic peptide (BNP) during short-term hypothyroidism.
Materials and Methods: The study was an 12-week controlled observational study. Nineteen female patients with differentiated thyroid cancer were recruited. Four patients had diabetes mellitus, and one of them had hypertension. All of them visited four times during the study period: on the 1st day after withdrawal of T4 (P1), on the 1st week after withdrawal of T4 (P2), on the 4th weeks after withdrawal of T4 (P3) and on the 8th weeks after RAI therapy (P4). The previous dose of T4 was given to each patient after RAI therapy. At the visiting, vital signs were checked and proBNP and echocardiography were performed.
Results: During short-term hypothyroidism (P3), TSH was 136.5±48.8 mIU/L and heart rate decreased significantly during short-term hypothyroidism. Stroke volume and ejection fraction was significantly decreased at P3, but those were recovered after T4 administration. There was no diastolic dysfunction during the study. ProBNP was decreased at P3 (p=0.021), but all the values were in normal range. There were no signs and symptoms of heart failure and cardiac ischemia.
Conclusion: Although short-term hypothyroidism induced systolic dysfunction, it didn’t induce the clinical problem. The withdrawal of thyroid hormone can safely be prescribed to patients with low cardiac risk.
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KEYWORD
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Hypothyroidism, Thyroid cancer, Echocardiography, Brain natriuretic peptide, Radioiodine therapy
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