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A Prospective Comparative Study on Improvement of Hyperthyroid Cardiovascular Dysfunction in Patients Undergoing Total Thyroidectomy Versus Medical Management.

Abstract：

INTRODUCTION:Cardiovascular dysfunction (CVD) is a well-recognized complication in patients with hyperthyroidism and is the major cause of mortality. Very few studies have compared the outcome of CVD following different treatment modalities. In this study we intended to compare treatment modalities (antithyroid drugs vs surgery) for reversal of CVD. MATERIALS AND METHODS:Patients with newly detected hyperthyroidism were grouped into, Group I [n = 123, age <60 years, undergoing total thyroidectomy], Group II [n = 42, age <60 years, treated with antithyroid medications] were evaluated with 2D echocardiography, serum N terminal pro brain natriuretic peptide (NT-pro-BNP) at the time of diagnosis (Point A), after achieving euthyroidism (Point B) with antithyroid drugs and 6 months after surgery/continuation of antithyroid medications (Point C). Forty patients (Group III), age < 60 years, undergoing total thyroidectomy for nontoxic benign thyroid nodules served as controls. RESULTS:All groups were age and sex matched. At Point A, CVD was evident in 80/123 (65%) in Group I and 28/42 (66.7%) in Group II. At Point B improvement in CVD occurred in 84/123 (68.3%) in Group and 29/42 (69.04%) in Group II. At Point C dramatic improvement in CVD occurred in 118/123 (95.9%) in Group I, whereas only 33/42 (78.5%) improved in Group II. CVD were comparable between Groups I and II at Point A and Point B (p > 0.05). At Point C there was a significant decrease in all the diastolic dysfunction parameters in Group I, whereas the same was not observed in Group II patients. Systolic dysfunction between Groups II and II had no statistical significance at Point C. CONCLUSION:Total thyroidectomy seems to be the definitive treatment of choice for hyperthyroid cardiac dysfunction with diastolic dysfunction completely reversing at 6 months after TT.

journal_name

World J Surg

journal_title

World journal of surgery

authors

Muthukumar S,Ravikumar K,Dhalapathy S,Gomathy T,Umadevi S,Maruthupandian D

doi

10.1007/s00268-018-4571-4

subject

Has Abstract

pub_date

2018-05-01 00:00:00

pages

1408-1414

issue

eissn

0364-2313

issn

1432-2323

pii

10.1007/s00268-018-4571-4

journal_volume

pub_type

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A Prospective Comparative Study on Improvement of Hyperthyroid Cardiovascular Dysfunction in Patients Undergoing Total Thyroidectomy Versus Medical Management.