The Effect of Brief Thyroid Functional Changes on Arterial Stiffness in Patients Who Preparing Radioactive Iodine Administration
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background and Objectives: Abnormal thyroid function influences the cardiovascular system. In particular, brief thyroid functional change due to levothyroxine (LT4) suppression therapy and withdrawal in papillary thyroid cancer (PTC) patients can affect cardiovascular system and other biochemical markers. However, the effect of brief thyroid functional change on arterial stiffness has not been evaluated. Therefore, we evaluated the changes in arterial stiffness according to short-term thyroid hormone levels in patients who underwent total thyroidectomy and radioactive iodine (RAI) therapy for PTC. Materials and Methods: Patients with PTC (n=17; 15 females, mean age 52 years) who underwent total thyroidectomy and RAI therapy were enrolled in this study. The arterial stiffness was evaluated using the corrected augmentation index for heart rate (AI@75) and brachial-ankle pulse wave velocity (BaPWV). Serum thyroid hormone levels and arterial stiffness parameters were checked three times consecutively: the day before thyroidectomy (Visit 1; baseline euthyroid state), after LT4 withdrawal (Visit 2; pre-RAI hypothyroid state) and 4 weeks after RAI (Visit 3; post-RAI thyrotoxic state). Biochemical markers, which can influence the arterial stiffness, were also measured. Results: The heart rate, AI@75 and serum thyroid hormone levels changed significantly at each visit. BaPWV was not significantly changed. Changes in AI@75 correlated with systolic blood pressure (SBP), serum thyroid hormone levels, total cholesterol and high density lipoprotein cholesterol in univariate analysis. In multivariate analysis, SBP was the independent factor for AI@75 changes. Conclusion: These results suggest that brief thyroid functional changes can influence AI@75. And SBP was important factor for AI@75 change.
Abstract
Background and Objectives: Abnormal thyroid function influences the cardiovascular system. In particular, brief thyroid functional change due to levothyroxine (LT4) suppression therapy and withdrawal in papillary thyroid cancer (PTC) patients can affect cardiovascular system and other biochemical markers. However, the effect of brief thyroid functional change on arterial stiffness has not been evaluated. Therefore, we evaluated the changes in arterial stiffness according to short-term thyroid hormone levels in patients who underwent total thyroidectomy and radioactive iodine (RAI) therapy for PTC. Materials and Methods: Patients with PTC (n=17; 15 females, mean age 52 years) who underwent total thyroidectomy and RAI therapy were enrolled in this study. The arterial stiffness was evaluated using the corrected augmentation index for heart rate (AI@75) and brachial-ankle pulse wave velocity (BaPWV). Serum thyroid hormone levels and arterial stiffness parameters were checked three times consecutively: the day before thyroidectomy (Visit 1; baseline euthyroid state), after LT4 withdrawal (Visit 2; pre-RAI hypothyroid state) and 4 weeks after RAI (Visit 3; post-RAI thyrotoxic state). Biochemical markers, which can influence the arterial stiffness, were also measured. Results: The heart rate, AI@75 and serum thyroid hormone levels changed significantly at each visit. BaPWV was not significantly changed. Changes in AI@75 correlated with systolic blood pressure (SBP), serum thyroid hormone levels, total cholesterol and high density lipoprotein cholesterol in univariate analysis. In multivariate analysis, SBP was the independent factor for AI@75 changes. Conclusion: These results suggest that brief thyroid functional changes can influence AI@75. And SBP was important factor for AI@75 change.
참고문헌 (31)
- Klein I, "Thyroid disease and the heart", Circulation, 116(15), pp.1725~1735 (2007)
- Nagasaki T, "Decrease of brachial-ankle pulse wave velocity in female subclinical hypothyroid patients during normalization of thyroid function: a double-blind, placebo-controlled study", Eur J Endocrinol, 160(3), pp.409~415 (2009)
- Volzke H, "Thyroid function and carotid wall thickness", J Clin Endocrinol Metab, 89(5), pp.2145~2149 (2004)
- Napoli R, "Impact of hyperthyroidism and its correction on vascular reactivity in humans", Circulation, 104(25), pp.3076~3080 (2001)
- Bodlaj G, "Hyperthyroidism affects arterial stiffness, plasma NT-pro-B-type natriuretic peptide levels, and subendocardial perfusion in patients with Graves' disease", Ann Med, 39(8), pp.608~616 (2007)
- Cooper DS, "Management guidelines for patients with thyroid nodules and differentiated thyroid cancer", Thyroid, 16(2), pp.109~142 (2006)
- Duntas LH, "Short-term hypothyroidism after Levothyroxine-withdrawal in patients with differentiated thyroid cancer: clinical and quality of life consequences", Eur J Endocrinol, 156(1), pp.13~19 (2007)
- Botella-Carretero JI, "Chronic thyrotropinsuppressive therapy with levothyroxine and short-term overt hypothyroidism after thyroxine withdrawal are associated with undesirable cardiovascular effects in patients with differentiated thyroid carcinoma", Endocr Relat Cancer, 11(2), pp.345~356 (2004)
- Di Paola R, "Left ventricular function in acute hypothyroidism: a Doppler echocardiography study", Ital Heart J, 5(11), pp.857~863 (2004)
- Wieshammer S, "Acute hypothyroidism slows the rate of left ventricular diastolic relaxation", Can J Physiol Pharmacol, 67(9), pp.1007~1010 (1989)
- Fommei E, "The role of thyroid hormone in blood pressure homeostasis: evidence from short-term hypothyroidism in humans", J Clin Endocrinol Metab, 87(5), pp.1996~2000 (2002)
- Hoftijzer HC, "Short-term overt hypothyroidism induces discrete diastolic dysfunction in patients treated for differentiated thyroid carcinoma", Eur J Clin Invest, 39(3), pp.204~210 (2009)
- Matsui Y, "Reproducibility of arterial stiffness indices (pulse wave velocity and augmentation index) simultaneously assessed by automated pulse wave analysis and their associated risk factors in essential hypertensive patients", Hypertens Res, 27(11), pp.851~857 (2004)
- Waddell TK, "Carotid pressure is a better predictor of coronary artery disease severity than brachial pressure", Hypertension, 38(4), pp.927~931 (2001)
- Chirinos JA, "Aortic pressure augmentation predicts adverse cardiovascular events in patients with established coronary artery disease", Hypertension, 45(5), pp.980~985 (2005)
- Richardson CJ, "Comparison of estimates of central systolic blood pressure and peripheral augmentation index obtained from the Omron HEM-9000AI and SphygmoCor systems", Artery Res, 3(1), pp.24~31 (2009)
- Hickson SS, "The accuracy of central SBP determined from the second systolic peak of the peripheral pressure waveform", J Hypertens, 27(9), pp.1784~1788 (2009)
- Diekman MJ, "Endocrine factors related to changes in total peripheral vascular resistance after treatment of thyrotoxic and hypothyroid patients", Eur J Endocrinol, 144(4), pp.339~346 (2001)
- Biondi B, "Hypothyroidism as a risk factor for cardiovascular disease", Endocrine, 24(1), pp.1~13 (2004)
- Duntas LH, "Thyroid disease and lipids", Thyroid, 12(4), pp.287~293 (2002)
- Obuobie K, "Increased central arterial stiffness in hypothyroidism", J Clin Endocrinol Metab, 87(10), pp.4662~4666 (2002)
- Obuobie K, "The effects of thyrotoxicosis and its treatment on central arterial stiffness", Eur J Endocrinol, 147(1), pp.35~40 (2002)
- Osman F, "Cardiovascular manifestations of hyperthyroidism before and after antithyroid therapy: a matched case-control study", J Am Coll Cardiol, 49(1), pp.71~81 (2007)
- Nagasaki T, "Increased pulse wave velocity in subclinical hypothyroidism", J Clin Endocrinol Metab, 91(1), pp.154~158 (2006)
- Razvi S, "The beneficial effect of L-thyroxine on cardiovascular risk factors, endothelial function, and quality of life in subclinical hypothyroidism: randomized, crossover trial", J Clin Endocrinol Metab, 92(5), pp.1715~1723 (2007)
- Napoli R, "Acute effects of triiodothyronine on endothelial function in human subjects", J Clin Endocrinol Metab, 92(1), pp.250~254 (2007)
- Dagre AG, "Arterial stiffness is increased in subjects with hypothyroidism", Int J Cardiol, 103(1), pp.1~6 (2005)
- Oliviero U, "Effects of long-term L-thyroxine treatment on endothelial function and arterial distensibility in young adults with congenital hypothyroidism", Eur J Endocrinol, 162(2), pp.289~294 (2010)
- Yavuz DG, "Exogenous subclinical hyperthyroidism impairs endothelial function in nodular goiter patients", Thyroid, 18(4), pp.395~400 (2008)
- 박경선, "무증상 갑상선기능저하증 환자와 정상 대조군 사이의 총경동맥 내중막두께 비교", Endocrinology and Metabolism, 21(6), pp.490~496 (2006), 대한내분비학회
- 장혁재, "Endothelial Function is Not Changed during Short-Term Withdrawal of Thyroxine in Patients with Differentiated Thyroid Cancer and Low Cardiovascular Risk", Yonsei Medical Journal, 51(4), pp.492~498 (2010), 연세대학교의과대학
