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

TitleIncidence, clinical characteristics and outcome of congestive heart failure as the initial presentation in patients with primary hyperthyroidism
Authors
Issue Date2007
PublisherB M J Publishing Group. The Journal's web site is located at http://heart.bmjjournals.com/
Citation
Heart, 2007, v. 93 n. 4, p. 483-487 How to Cite?
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<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.
Persistent Identifierhttp://hdl.handle.net/10722/57515
ISSN
2013 Impact Factor: 6.023
2013 SCImago Journal Rankings: 2.793
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorSiu, CWen_HK
dc.contributor.authorYeung, CYen_HK
dc.contributor.authorLau, CPen_HK
dc.contributor.authorKung, AWCen_HK
dc.contributor.authorTse, HFen_HK
dc.date.accessioned2010-04-12T01:38:55Z-
dc.date.available2010-04-12T01:38:55Z-
dc.date.issued2007en_HK
dc.identifier.citationHeart, 2007, v. 93 n. 4, p. 483-487en_HK
dc.identifier.issn1355-6037en_HK
dc.identifier.urihttp://hdl.handle.net/10722/57515-
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.en_HK
dc.languageengen_HK
dc.publisherB M J Publishing Group. The Journal's web site is located at http://heart.bmjjournals.com/en_HK
dc.relation.ispartofHearten_HK
dc.rightsHeart. Copyright © B M J Publishing Group.en_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshHeart Failure - etiologyen_HK
dc.subject.meshHyperthyroidism - complicationsen_HK
dc.subject.meshAged, 80 and overen_HK
dc.subject.meshCohort Studiesen_HK
dc.subject.meshFollow-Up Studiesen_HK
dc.titleIncidence, clinical characteristics and outcome of congestive heart failure as the initial presentation in patients with primary hyperthyroidismen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1355-6037&volume=93&issue=4&spage=483&epage=487&date=2007&atitle=Incidence,+clinical+characteristics+and+outcome+of+congestive+heart+failure+as+the+initial+presentation+in+patients+with+primary+hyperthyroidismen_HK
dc.identifier.emailSiu, CW:cwdsiu@hkucc.hku.hken_HK
dc.identifier.emailKung, AWC:awckung@hku.hken_HK
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_HK
dc.identifier.authoritySiu, CW=rp00534en_HK
dc.identifier.authorityKung, AWC=rp00368en_HK
dc.identifier.authorityTse, HF=rp00428en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.doi10.1136/hrt.2006.100628en_HK
dc.identifier.pmid17005710en_HK
dc.identifier.pmcidPMC1861478-
dc.identifier.scopuseid_2-s2.0-34247331316en_HK
dc.identifier.hkuros126507-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-34247331316&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume93en_HK
dc.identifier.issue4en_HK
dc.identifier.spage483en_HK
dc.identifier.epage487en_HK
dc.identifier.isiWOS:000245350000016-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridSiu, CW=7006550690en_HK
dc.identifier.scopusauthoridYeung, CY=36848789800en_HK
dc.identifier.scopusauthoridLau, CP=7401968501en_HK
dc.identifier.scopusauthoridKung, AWC=7102322339en_HK
dc.identifier.scopusauthoridTse, HF=7006070805en_HK

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