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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
2012 Impact Factor: 5.014
2012 SCImago Journal Rankings: 2.052
 
DOIhttp://dx.doi.org/10.1136/hrt.2006.100628
 
PubMed Central IDPMC1861478
 
ISI Accession Number IDWOS:000245350000016
 
ReferencesReferences in Scopus
 
DC FieldValue
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
2012 Impact Factor: 5.014
2012 SCImago Journal Rankings: 2.052
 
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
 
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<contributor.author>Tse, HF</contributor.author>
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<description.abstract>Background: 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&lt;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)&lt;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&lt;0.001) and New York Heart Association functional class (1.2 (0.1) vs 2.5 (0.2), p&lt;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&gt;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.</description.abstract>
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Author Affiliations
  1. The University of Hong Kong