Abstract |
The purpose of this study is to investigate the effects
of thyroid hormone on the left ventricular(LV) volume
and function in man with untreated hyperthyroidism and
to determine the effects of successful therapy for
thyrotoxicosis on the ventricular pathophysiology. In
the precent study, equilibrium ralhianuclide cardiac
angiography was performed and LV volume index, ejection
phase indexes of LV performance, serum thyroid hormone
levels and other hemodynamic parameters were measured
in 28 normal subjects and 39 patients with
hyperthyroidism before treatment and again every 4
weeks for the first 2 months after the initiation of
effective therapy. The result obtained were as follows;
1) In the untreated hyperthyroid state heart rate,
blood volume, cardiac index and stroke volume
index(97±14 beats/min, 73.5±11.8 ml/kg, 6.9±1.4
l/min/m2 and 77.6±13.8 ml/m2, respectively) were
increased significantly compared to those in normal
control(74±12beats/min, 65.6±14.8 ml/kg, 3.8±1.2
l/min/m2 and 56.6±13.2 ml/m2 respectively).
(Mean±SD). 2) There was a significant increase in LV
end-diastolic volume index in patients with
hyperthyroidism(30.5±7.5 for hyperthyroid group
compared to a normal control of 22.2±6.5;P〈0.001),
whereas end-systolic volume index remained unchanged
9.6±3.6 and 8.8±3.3 respectively). 3) In patients
with hyperthyroidism, LV ejection fraction was
70.0±5.6%, fractional shortening 32.9±5.1%, mean
velocity of circumferential fiber shortening(mean Vcf)
1.34±0.31 circ/sec and maximum ejection rate
3.47±0.80. All the ejection phase indexes were
significantly greater than those in normal
control(65.2±5.7%, 28.8±3.2%, 0.88±0.37 circ/sec and
2.27±0.50, respectively; p〈0.001). 4) Effective
therapy produced significant decrease in all the values
of serum thyroid hormone concenrations(p〈0.001),
hemodynamic parameters(p〈0.001), end-diastolic volume
index(p〈0.01) and ejection phase indexes of LV
contractility in patients with hyperthyroidism and
after one to two months, when the patients were |