This study was to investigate the influence of thyroid stimulating hormone (TSH) suppression time on the cardiac function of differentiated thyroid carcinoma (DTC) patients.
105 DTC patients were divided into strict TSH suppression group (model group, TSH ≤ 0.1 mU/L) and general TSH suppression group (control group, TSH > 0.1 mU/L). According to the suppression time, these two groups were respectively divided into three groups: group within half a year, group between half a year and a year and group more than a year. Gated myocardial perfusion imaging was applied to observe differences of left ventricle (LV) myocardial perfusion, LV diastolic and systolic function and LV systolic synchrony in every group.
The left ventricular diastolic function, systolic synchrony and myocardial perfusion level of model group decreased with prolonged suppression time. The values of left ventricular EF, PFR and BPM in patients less than half a year were higher than those in 6 months to 1 year for control group.
Thyroid stimulating hormone suppression can influence the cardiac function of patients and with the prolongation of suppression time, regardless of the level of TSH suppression, the possibility of cardiac function depression in patients will increase. TSH may lower the risk of cardiovascular disease in high-risk patients than those in TSH patients with moderate or low risk. The drugs improving cardiac function should be used cooperatively in different suppression period to decrease the occurrence rate of cardiac adverse reactions.
American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, Mazzaferri EL, McIver B, Pacini F, Schlumberger M, Sherman SI, Steward DL, Tuttle RM. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroidCancer. Thyroid. 2009;19:1167–214. CrossRef
Samuels MH, Kolobova I, Smeraglio A, Peters D, Janowsky JS, Schuff KG. The effects of levothyroxine replacement or suppressive therapy on health status, mood, and cognition. J Clin Endocrinol Metab. 2014;99:843–51. CrossRef
Gammage MD, Parle JV, Holder RL, Roberts LM, Hobbs FD, Wilson S, Sheppard MC, Franklyn JA. Association between serum free thyroxine concentration and atrial fibrillation. Arch Intern Med. 2007;167:928–34. CrossRef
Biondi B, Palmieri EA, Lombardi G, Fazio S. Effects of thyroid hormone on cardiac function: the relative importance of heart rate, loading conditions, and myocardial contractility in the regulation of cardiac performance in human hyperthyroidism. J Clin Endocrinol Metab. 2002;87:968–74. CrossRef
Fazio S, Palmieri EA, Lombardi G, Biondi B. Effects of thyroid hormone on the cardiovascular system. Recent Prog Horm Res. 2004;59:31–50. CrossRef
Gazdag A, Nagy EV, Erdei A, Bodor M, Berta E, Szabó Z, Jenei Z. Aortic stiffness and left ventricular function in patients with differentiated thyroid cancer. J Endocrinol Invest. 2015;38:133–42. CrossRef
Cooper DS, Specker B, Ho M, Sperling M, Ladenson PW, Ross DS, Ain KB, Bigos ST, Brierley JD, Haugen BR, Klein I, Robbins J, Sherman SI, Taylor T, Maxon HR 3rd. Thyrotropin suppression and disease progression in patients with differentiated thyroid cancer: results from the National Thyroid Cancer Treatment Cooperative Registry. Thyroid Off J Am Thyroid Assoc. 1998;8:737. CrossRef
Sugitani I, Fujimoto Y. Effect of postoperative thyrotropin suppressive therapy on bone mineral density in patients with papillary thyroid carcinoma: a prospective controlled study. Surgery. 2011;150:1250. CrossRef
Chen J, Garcia EV, Bax JJ, Iskandrian AE, Borges-Neto S, Soman P. SPECT myocardial perfusion imaging for the assessment of left ventricular mechanical dyssynchrony. J Nucl Cardiol. 2011;18:685–94. CrossRef
Haugen BR, Sawka AM, Alexander EK, Bible KC, Caturegli P, Doherty GM, Mandel SJ, Morris JC, Nassar A, Pacini F, Schlumberger M, Schuff K, Sherman SI, Somerset H, Sosa JA, Steward DL, Wartofsky L, Williams MD. American thyroid association guidelines on the management of thyroid nodules and differentiated thyroid cancer task force review and recommendation on the proposed renaming of encapsulated follicular variant papillary thyroid carcinoma without invasion to noninvasive follicular thyroid neoplasm with papillary-like nuclear features. Thyroid Off J Am Thyroid Assoc. 2017;27:481–3. CrossRef
Taillard V, Sardinoux M, Oudot C, Fesler P, Rugale C, Raingeard I, Renard E, Ribstein J, du Cailar G. Early detection of isolated left ventricular diastolic dysfunction in high-risk differentiated thyroid carcinoma patients on TSH-suppressive therapy. Clin Endocrinol (Oxf). 2011;75:709–14. CrossRef
Estes NA 3rd, Halperin JL, Calkins H, Ezekowitz MD, Gitman P, Go AS, McNamara RL, Messer JV, Ritchie JL, Romeo SJ, Waldo AL, Wyse DG, American College of Cardiology/American Heart Association Task Force on Performance Measures, Physician Consortium for Performance Improvement (Writing Committee to Develop Clinical Performance Measures for Atrial Fibrillation), Heart Rhythm Society. ACC/AHA/Physician Consortium 2008 clinical performance measures for adults with nonvalvular atrial fibrillation or atrial flutter: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures and the Physician Consortium for Performance Improvement (Writing Committee to Develop Clinical Performance Measures for Atrial Fibrillation): developed in collaboration with the Heart Rhythm Society. Circulation. 2008;117:1101–20. CrossRef
Belluzzi F, Sernesi L, Preti P, Salinaro F, Fonte ML, Perlini S. Prevention of recurrent lone atrial fibrillation by the angiotensin-II converting enzyme inhibitor ramipril in normotensive patients. J Am Coll Cardiol. 2009;53:24–9. CrossRef
Radford MJ, Arnold JM, Bennett SJ, Cinquegrani MP, Cleland JG, Havranek EP, Heidenreich PA, Rutherford JD, Spertus JA, Stevenson LW, Goff DC, Grover FL, Malenka DJ, Peterson ED, Redberg RF, American College of Cardiology, American Heart Association Task Force on Clinical Data Standards, American College of Chest Physicians, International Society for Heart and Lung Transplantation, Heart Failure Society of America. ACC/AHA key data elements and definitions for measuring the clinical management and outcomes of patients with chronic heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Heart Failure Clinical Data Standards): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Failure Society of America. Circulation. 2005;112:1888–916. CrossRef
Biondi B, Fazio S, Carella C, Sabatini D, Amato G, Cittadini A, Bellastella A, Lombardi G, Saccà L. Control of adrenergic overactivity by beta-blockade improves the quality of life in patients receiving long term suppressive therapy with levothyroxine. J Clin Endocrinol Metab. 1994;78:1028–33. PubMed
Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, Tuttle RM, Wartofsky L. 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the american thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26:1–133. CrossRef
Shargorodsky M, Serov S, Gavish D, Leibovitz E, Harpaz D, Zimlichman R. Long-term thyrotropin-suppressive therapy with levothyroxine impairs small and large artery elasticity and increases left ventricular mass in patients with thyroid carcinoma. Thyroid. 2006;16:381–6. CrossRef
Bahn RS, Burch HB, Cooper DS, Garber JR, Greenlee MC, Klein I, Laurberg P, McDougall IR, Montori VM, Rivkees SA, Ross DS, Sosa JA, Stan MN, American Thyroid Association, American Association of Clinical Endocrinologists. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American thyroid association and American association of clinical endocrinologists. Endocr Pract. 2011;17:456–520. CrossRef
Gullu S, Altuntas F, Dincer I, Erol C, Kamel N. Effects of TSH-suppressive therapy on cardiac morphology and function: beneficial effects of the addition of beta-blockade on diastolic dysfunction. Eur J Endocrinol. 2004;150:655–61. CrossRef
Dahl P, Danzi S, Klein I. Thyrotoxic cardiac disease. Curr Heart Failure Rep. 2008;5:170–6. CrossRef
Xing W, Zhao J. TSH in the upper limits of the normal range is associated with an adverse lipid profile in euthyroid non-diabetics with newly diagnosed asymptomatic coronary heart disease. Heart. 2012;98:E161–2. CrossRef
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