Article: Incidence, clinical characteristics and outcome of congestive heart failure as the initial presentation in patients with primary hyperthyroidism

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TitleIncidence, clinical characteristics and outcome of congestive heart failure as the initial presentation in patients with primary hyperthyroidism
AuthorsSiu, CW1
Yeung, CY1
Lau, CP1
Kung, AWC1
Tse, HF1
Issue Date2007
PublisherB M J Publishing Group. The Journal's web site is located at http://heart.bmjjournals.com/
CitationHeart, 2007, v. 93 n. 4, p. 483-487 [How to Cite?]
DOI: http://dx.doi.org/10.1136/hrt.2006.100628
AbstractBackground: There are limited systematic data on the incidence, clinical characteristics and outcomes of congestive heart failure (CHF) in patients with hyperthyroidism. The aim of this study was to investigate the incidence, clinical characteristics and outcome of CHF as the initial presentation in patients with primary hyperthyroidism. Methods: The prevalence, clinical characteristics and outcome of CHF was studied in 591 consecutive patients (mean (SD) age 45 (1) years, 140 men) who presented with primary hyperthyroidism. Results: CHF was the presenting condition in 34 patients (5.8%) with hyperthyroidism. The presence of atrial fibrillation at presentation (OR 37.4, 95% CI 9.72 to 144.0, p<0.001) was an independent predictor for the occurrence of CHF. Of the 34 patients with CHF, 16 (47%) had systolic left ventricular dysfunction with left ventricular ejection fraction (LVEF)<50%. They were predominantly male (OR 26.6, 95% CI 2.6 to 272.5, p = 0.006) and had a lower serum thyroxine level (OR 0.93, 95% CI 0.87 to 0.99, p = 0.044) than patients with preserved left ventricular systolic function. In these patients, LVEF (55 (4)% vs 30 (2)%, p<0.001) and New York Heart Association functional class (1.2 (0.1) vs 2.5 (0.2), p<0.001) improved significantly 3 months after achieving euthyroid status. Systolic left ventricular dysfunction (mean (SD) LVEF 38 (4)%) persisted on long-term follow-up in five patients: no clinical parameter could be identified to predict the occurrence of this persistent cardiomyopathy (p>0.05). Conclusion: CHF was the initial clinical presentation in approximately 6% of patients with hyperthyroidism, and half of them had left ventricular systolic dysfunction. Symptoms of CHF subsided and LVEF improved after treatment for hyperthyroidism. Nonetheless, one-third of these patients developed persistent dilated cardiomyopathy.
ISSN1355-6037
2011 Impact Factor: 4.223
2011 SCImago Journal Rankings: 0.348
DOIhttp://dx.doi.org/10.1136/hrt.2006.100628
ISI Accession Number IDWOS:000245350000016
PubMed Central IDPMC1861478
ReferencesReferences in Scopus
DC Field
Value
dc.contributor.authorSiu, CW
dc.contributor.authorYeung, CY
dc.contributor.authorLau, CP
dc.contributor.authorKung, AWC
dc.contributor.authorTse, HF
dc.date.accessioned2010-04-12T01:38:55Z
dc.date.available2010-04-12T01:38:55Z
dc.date.issued2007
dc.description.abstractBackground: There are limited systematic data on the incidence, clinical characteristics and outcomes of congestive heart failure (CHF) in patients with hyperthyroidism. The aim of this study was to investigate the incidence, clinical characteristics and outcome of CHF as the initial presentation in patients with primary hyperthyroidism. Methods: The prevalence, clinical characteristics and outcome of CHF was studied in 591 consecutive patients (mean (SD) age 45 (1) years, 140 men) who presented with primary hyperthyroidism. Results: CHF was the presenting condition in 34 patients (5.8%) with hyperthyroidism. The presence of atrial fibrillation at presentation (OR 37.4, 95% CI 9.72 to 144.0, p<0.001) was an independent predictor for the occurrence of CHF. Of the 34 patients with CHF, 16 (47%) had systolic left ventricular dysfunction with left ventricular ejection fraction (LVEF)<50%. They were predominantly male (OR 26.6, 95% CI 2.6 to 272.5, p = 0.006) and had a lower serum thyroxine level (OR 0.93, 95% CI 0.87 to 0.99, p = 0.044) than patients with preserved left ventricular systolic function. In these patients, LVEF (55 (4)% vs 30 (2)%, p<0.001) and New York Heart Association functional class (1.2 (0.1) vs 2.5 (0.2), p<0.001) improved significantly 3 months after achieving euthyroid status. Systolic left ventricular dysfunction (mean (SD) LVEF 38 (4)%) persisted on long-term follow-up in five patients: no clinical parameter could be identified to predict the occurrence of this persistent cardiomyopathy (p>0.05). Conclusion: CHF was the initial clinical presentation in approximately 6% of patients with hyperthyroidism, and half of them had left ventricular systolic dysfunction. Symptoms of CHF subsided and LVEF improved after treatment for hyperthyroidism. Nonetheless, one-third of these patients developed persistent dilated cardiomyopathy.
dc.description.naturepublished_or_final_version
dc.identifier.citationHeart, 2007, v. 93 n. 4, p. 483-487 [How to Cite?]
DOI: http://dx.doi.org/10.1136/hrt.2006.100628
dc.identifier.doihttp://dx.doi.org/10.1136/hrt.2006.100628
dc.identifier.epage487
dc.identifier.hkuros126507
dc.identifier.isiWOS:000245350000016
dc.identifier.issn1355-6037
2011 Impact Factor: 4.223
2011 SCImago Journal Rankings: 0.348
dc.identifier.issue4
dc.identifier.openurl
dc.identifier.pmcidPMC1861478
dc.identifier.pmid17005710
dc.identifier.scopuseid_2-s2.0-34247331316
dc.identifier.spage483
dc.identifier.urihttp://hdl.handle.net/10722/57515
dc.identifier.volume93
dc.languageeng
dc.publisherB M J Publishing Group. The Journal's web site is located at http://heart.bmjjournals.com/
dc.publisher.placeUnited Kingdom
dc.relation.ispartofHeart
dc.relation.referencesReferences in Scopus
dc.rightsHeart. Copyright © B M J Publishing Group.
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License
dc.subject.meshHeart Failure - etiology
dc.subject.meshHyperthyroidism - complications
dc.subject.meshAged, 80 and over
dc.subject.meshCohort Studies
dc.subject.meshFollow-Up Studies
dc.titleIncidence, clinical characteristics and outcome of congestive heart failure as the initial presentation in patients with primary hyperthyroidism
dc.typeArticle
Author Affiliations
  1. The University of Hong Kong