Heart rate variability and turbulence in hyperthyroidism before, during, and after treatment
Patients with subclinical and treated overt hyperthyroidism have an excess vascular mortality rate. Several symptoms and signs in overt hyperthyroidism suggest abnormality of cardiac autonomic function that may account in part for this excess mortality rate, but few studies have examined cardiac aut...
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| Veröffentlicht in: | The American journal of cardiology 2004-08, Vol.94 (4), p.465-469 |
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| creator | Osman, Faizel Franklyn, Jayne A. Daykin, Jacqueline Chowdhary, Saqib Holder, Roger L. Sheppard, Michael C. Gammage, Michael D. |
| description | Patients with subclinical and treated overt hyperthyroidism have an excess vascular mortality rate. Several symptoms and signs in overt hyperthyroidism suggest abnormality of cardiac autonomic function that may account in part for this excess mortality rate, but few studies have examined cardiac autonomic function in untreated and treated hyperthyroidism. We assessed heart rate turbulence (HRT) and time-domain parameters of heart rate variability in a large, unselected cohort of patients with overt hyperthyroidism referred to our thyroid clinic (n = 259) and compared findings with a group of normal subjects with euthyroidism (n = 440). These measures were also evaluated during antithyroid therapy (when serum-free thyroxine and triiodothyronine concentrations returned to normal but thyrotropin remained suppressed (i.e., subclinical hyperthyroidism, n = 110) and when subjects were rendered clinically and biochemically euthyroid (normal serum thyrotropin, free thyroxine and triiodothyronine concentrations, n = 219). We found that overall measures of heart rate variability and those specific for cardiac vagal modulation were attenuated in patients with overt hyperthyroidism compared with normal subjects; measurements of overall heart rate variability remained low in those with low levels of serum thyrotropin but returned to normal in patients with biochemical euthyroidism. Measurements of HRT (onset and slope) were also decreased in patients with overt hyperthyroidism, but HRT slope returned to normal values with antithyroid treatment. This study is the first to evaluate HRT in overt and treated hyperthyroidism. |
| doi_str_mv | 10.1016/j.amjcard.2004.04.061 |
| format | Article |
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Several symptoms and signs in overt hyperthyroidism suggest abnormality of cardiac autonomic function that may account in part for this excess mortality rate, but few studies have examined cardiac autonomic function in untreated and treated hyperthyroidism. We assessed heart rate turbulence (HRT) and time-domain parameters of heart rate variability in a large, unselected cohort of patients with overt hyperthyroidism referred to our thyroid clinic (n = 259) and compared findings with a group of normal subjects with euthyroidism (n = 440). These measures were also evaluated during antithyroid therapy (when serum-free thyroxine and triiodothyronine concentrations returned to normal but thyrotropin remained suppressed (i.e., subclinical hyperthyroidism, n = 110) and when subjects were rendered clinically and biochemically euthyroid (normal serum thyrotropin, free thyroxine and triiodothyronine concentrations, n = 219). We found that overall measures of heart rate variability and those specific for cardiac vagal modulation were attenuated in patients with overt hyperthyroidism compared with normal subjects; measurements of overall heart rate variability remained low in those with low levels of serum thyrotropin but returned to normal in patients with biochemical euthyroidism. Measurements of HRT (onset and slope) were also decreased in patients with overt hyperthyroidism, but HRT slope returned to normal values with antithyroid treatment. This study is the first to evaluate HRT in overt and treated hyperthyroidism.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2004.04.061</identifier><identifier>PMID: 15325930</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antithyroid Agents - therapeutic use ; Autonomic Nervous System - drug effects ; Autonomic Nervous System - physiopathology ; Cohort Studies ; Combined Modality Therapy ; Comparative studies ; Electrocardiography, Ambulatory - statistics & numerical data ; Female ; Heart ; Heart Rate - drug effects ; Heart Rate - physiology ; Humans ; Hyperthyroidism - drug therapy ; Hyperthyroidism - physiopathology ; Male ; Mathematical Computing ; Measures of variability ; Medical treatment ; Middle Aged ; Mortality ; Reference Values ; Signal Processing, Computer-Assisted ; Tachycardia, Paroxysmal - diagnosis ; Tachycardia, Paroxysmal - physiopathology ; Thyroid Crisis - drug therapy ; Thyroid Crisis - physiopathology ; Thyroid gland ; Thyrotropin - blood ; Thyroxine - blood ; Triiodothyronine - blood ; Vagus Nerve - drug effects ; Vagus Nerve - physiopathology ; Ventricular Premature Complexes - diagnosis ; Ventricular Premature Complexes - physiopathology</subject><ispartof>The American journal of cardiology, 2004-08, Vol.94 (4), p.465-469</ispartof><rights>2004 Excerpta Medica Inc.</rights><rights>Copyright Elsevier Sequoia S.A. 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Several symptoms and signs in overt hyperthyroidism suggest abnormality of cardiac autonomic function that may account in part for this excess mortality rate, but few studies have examined cardiac autonomic function in untreated and treated hyperthyroidism. We assessed heart rate turbulence (HRT) and time-domain parameters of heart rate variability in a large, unselected cohort of patients with overt hyperthyroidism referred to our thyroid clinic (n = 259) and compared findings with a group of normal subjects with euthyroidism (n = 440). These measures were also evaluated during antithyroid therapy (when serum-free thyroxine and triiodothyronine concentrations returned to normal but thyrotropin remained suppressed (i.e., subclinical hyperthyroidism, n = 110) and when subjects were rendered clinically and biochemically euthyroid (normal serum thyrotropin, free thyroxine and triiodothyronine concentrations, n = 219). We found that overall measures of heart rate variability and those specific for cardiac vagal modulation were attenuated in patients with overt hyperthyroidism compared with normal subjects; measurements of overall heart rate variability remained low in those with low levels of serum thyrotropin but returned to normal in patients with biochemical euthyroidism. Measurements of HRT (onset and slope) were also decreased in patients with overt hyperthyroidism, but HRT slope returned to normal values with antithyroid treatment. This study is the first to evaluate HRT in overt and treated hyperthyroidism.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antithyroid Agents - therapeutic use</subject><subject>Autonomic Nervous System - drug effects</subject><subject>Autonomic Nervous System - physiopathology</subject><subject>Cohort Studies</subject><subject>Combined Modality Therapy</subject><subject>Comparative studies</subject><subject>Electrocardiography, Ambulatory - statistics & numerical data</subject><subject>Female</subject><subject>Heart</subject><subject>Heart Rate - drug effects</subject><subject>Heart Rate - physiology</subject><subject>Humans</subject><subject>Hyperthyroidism - drug therapy</subject><subject>Hyperthyroidism - physiopathology</subject><subject>Male</subject><subject>Mathematical Computing</subject><subject>Measures of variability</subject><subject>Medical treatment</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Reference Values</subject><subject>Signal Processing, Computer-Assisted</subject><subject>Tachycardia, Paroxysmal - diagnosis</subject><subject>Tachycardia, Paroxysmal - physiopathology</subject><subject>Thyroid Crisis - drug therapy</subject><subject>Thyroid Crisis - physiopathology</subject><subject>Thyroid gland</subject><subject>Thyrotropin - blood</subject><subject>Thyroxine - blood</subject><subject>Triiodothyronine - blood</subject><subject>Vagus Nerve - drug effects</subject><subject>Vagus Nerve - physiopathology</subject><subject>Ventricular Premature Complexes - diagnosis</subject><subject>Ventricular Premature Complexes - physiopathology</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1rFEEQhhtRzCb6E5TGg6fM2h_TPdMnCcEYIeBFb0LTHzWmh_lYq3sC---dcRcEL0JBUfDUW8VDyBvO9pxx_aHfu7EPDuNeMFbvt9L8GdnxtjEVN1w-JzvGmKgMr80Fucy5X0fOlX5JLriSQhnJduTHPTgsFF0B-uQwOZ-GVI7UTZGWBf0ywBSApok-Hg-A5fGIc4opj9RDNyNc07hgmn5e_9lwXQGkBcGVEabyirzo3JDh9blfke93n77d3lcPXz9_ub15qEKt6lLJOoKuG850KzpoVNA-8EZE0wRolfLcMF0z3kIIHfOdiV52znsthW9Yy4W8Iu9PuQecfy2Qix1TDjAMboJ5yVbrlmkj-Aq--wfs5wWn9TcrJJPKqNaskDpBAeecETp7wDQ6PFrO7Obe9vbs3m7u7VZ6C397Dl_8CPHv1ln2Cnw8AbC6eEqANoe06Y0JIRQb5_SfE78B6iiYBw</recordid><startdate>20040815</startdate><enddate>20040815</enddate><creator>Osman, Faizel</creator><creator>Franklyn, Jayne A.</creator><creator>Daykin, Jacqueline</creator><creator>Chowdhary, Saqib</creator><creator>Holder, Roger L.</creator><creator>Sheppard, Michael C.</creator><creator>Gammage, Michael D.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20040815</creationdate><title>Heart rate variability and turbulence in hyperthyroidism before, during, and after treatment</title><author>Osman, Faizel ; Franklyn, Jayne A. ; Daykin, Jacqueline ; Chowdhary, Saqib ; Holder, Roger L. ; Sheppard, Michael C. ; Gammage, Michael D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c454t-34de64710682fe75c6bc172d97ce855b19064018eccf0bf9db3fabb632b708123</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antithyroid Agents - therapeutic use</topic><topic>Autonomic Nervous System - drug effects</topic><topic>Autonomic Nervous System - physiopathology</topic><topic>Cohort Studies</topic><topic>Combined Modality Therapy</topic><topic>Comparative studies</topic><topic>Electrocardiography, Ambulatory - statistics & numerical data</topic><topic>Female</topic><topic>Heart</topic><topic>Heart Rate - drug effects</topic><topic>Heart Rate - physiology</topic><topic>Humans</topic><topic>Hyperthyroidism - drug therapy</topic><topic>Hyperthyroidism - physiopathology</topic><topic>Male</topic><topic>Mathematical Computing</topic><topic>Measures of variability</topic><topic>Medical treatment</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Reference Values</topic><topic>Signal Processing, Computer-Assisted</topic><topic>Tachycardia, Paroxysmal - diagnosis</topic><topic>Tachycardia, Paroxysmal - physiopathology</topic><topic>Thyroid Crisis - drug therapy</topic><topic>Thyroid Crisis - physiopathology</topic><topic>Thyroid gland</topic><topic>Thyrotropin - blood</topic><topic>Thyroxine - blood</topic><topic>Triiodothyronine - blood</topic><topic>Vagus Nerve - drug effects</topic><topic>Vagus Nerve - physiopathology</topic><topic>Ventricular Premature Complexes - diagnosis</topic><topic>Ventricular Premature Complexes - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Osman, Faizel</creatorcontrib><creatorcontrib>Franklyn, Jayne A.</creatorcontrib><creatorcontrib>Daykin, Jacqueline</creatorcontrib><creatorcontrib>Chowdhary, Saqib</creatorcontrib><creatorcontrib>Holder, Roger L.</creatorcontrib><creatorcontrib>Sheppard, Michael C.</creatorcontrib><creatorcontrib>Gammage, Michael D.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Osman, Faizel</au><au>Franklyn, Jayne A.</au><au>Daykin, Jacqueline</au><au>Chowdhary, Saqib</au><au>Holder, Roger L.</au><au>Sheppard, Michael C.</au><au>Gammage, Michael D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Heart rate variability and turbulence in hyperthyroidism before, during, and after treatment</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2004-08-15</date><risdate>2004</risdate><volume>94</volume><issue>4</issue><spage>465</spage><epage>469</epage><pages>465-469</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Patients with subclinical and treated overt hyperthyroidism have an excess vascular mortality rate. Several symptoms and signs in overt hyperthyroidism suggest abnormality of cardiac autonomic function that may account in part for this excess mortality rate, but few studies have examined cardiac autonomic function in untreated and treated hyperthyroidism. We assessed heart rate turbulence (HRT) and time-domain parameters of heart rate variability in a large, unselected cohort of patients with overt hyperthyroidism referred to our thyroid clinic (n = 259) and compared findings with a group of normal subjects with euthyroidism (n = 440). These measures were also evaluated during antithyroid therapy (when serum-free thyroxine and triiodothyronine concentrations returned to normal but thyrotropin remained suppressed (i.e., subclinical hyperthyroidism, n = 110) and when subjects were rendered clinically and biochemically euthyroid (normal serum thyrotropin, free thyroxine and triiodothyronine concentrations, n = 219). We found that overall measures of heart rate variability and those specific for cardiac vagal modulation were attenuated in patients with overt hyperthyroidism compared with normal subjects; measurements of overall heart rate variability remained low in those with low levels of serum thyrotropin but returned to normal in patients with biochemical euthyroidism. Measurements of HRT (onset and slope) were also decreased in patients with overt hyperthyroidism, but HRT slope returned to normal values with antithyroid treatment. This study is the first to evaluate HRT in overt and treated hyperthyroidism.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>15325930</pmid><doi>10.1016/j.amjcard.2004.04.061</doi><tpages>5</tpages></addata></record> |
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| ispartof | The American journal of cardiology, 2004-08, Vol.94 (4), p.465-469 |
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| subjects | Adolescent Adult Aged Aged, 80 and over Antithyroid Agents - therapeutic use Autonomic Nervous System - drug effects Autonomic Nervous System - physiopathology Cohort Studies Combined Modality Therapy Comparative studies Electrocardiography, Ambulatory - statistics & numerical data Female Heart Heart Rate - drug effects Heart Rate - physiology Humans Hyperthyroidism - drug therapy Hyperthyroidism - physiopathology Male Mathematical Computing Measures of variability Medical treatment Middle Aged Mortality Reference Values Signal Processing, Computer-Assisted Tachycardia, Paroxysmal - diagnosis Tachycardia, Paroxysmal - physiopathology Thyroid Crisis - drug therapy Thyroid Crisis - physiopathology Thyroid gland Thyrotropin - blood Thyroxine - blood Triiodothyronine - blood Vagus Nerve - drug effects Vagus Nerve - physiopathology Ventricular Premature Complexes - diagnosis Ventricular Premature Complexes - physiopathology |
| title | Heart rate variability and turbulence in hyperthyroidism before, during, and after treatment |
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