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Cited by 121Pulmonary Hypertension Research and TreatmentsThyroid Disorders and TreatmentsCardiovascular Function and Risk Factors

Hemodynamic changes in hyperthyroidism-related pulmonary hypertension: a prospective echocardiographic study

Siu, Chung-Wah, Zhang, Xue-Hua, Yung, Cindy, Kung, Annie W. C., Lau, Chu-Pak, Tse, Hung-Fat·2007·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.2006-1877
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Abstract

CONTEXT: Recent reports suggest an association between hyperthyroidism and pulmonary hypertension (PHT), although the potential mechanisms and clinical implications remain unclear. OBJECTIVE: Our objective was to determine the prevalence of PHT related to hyperthyroidism and the associated hemodynamic changes and outcome. METHODS AND RESULTS: We performed serial echocardiographic examinations in 75 consecutive patients with hyperthyroidism (43 +/- 2 yr, 47 women) to estimate pulmonary artery systolic pressure (PASP), cardiac output (CO), total vascular resistance (TVR), and left ventricular (LV) filling pressure. Examinations were performed at baseline and 6 months after initiation of antithyroid treatment. Results were compared with 35 age- and sex-matched healthy controls. All hyperthyroid patients had normal LV systolic function, and 35 patients (47%) had PHT with PASP of at least 35 mm Hg. There were no significant differences in the clinical characteristics of hyperthyroid patients with or without PHT (all P > 0.05). Nonetheless, those with PHT had significantly higher CO, PASP, peak transmitral early diastolic flow velocity (E), and ratio of E to early diastolic mitral annular velocity (E') compared with those without PHT and controls (all P < 0.05). Hyperthyroid patients with PHT also had significantly lower TVR than controls (P < 0.05). Among the 35 hyperthyroid patients with PHT, 25 (71%) had pulmonary arterial hypertension (PAH) with normal E/E', and 10 (29%) had pulmonary venous hypertension (PVH) with elevated E/E'. Hyperthyroid patients with PAH had a significantly higher CO and a lower TVR compared with those with PVH. In contrast, hyperthyroid patients with PVH had lower E' and a higher E/E' ratio compared with those with PAH. These hemodynamic abnormalities and PHT were reversible in patients with PAH or PVH after restoration to a euthyroid state. CONCLUSION: In patients with hyperthyroidism and normal LV systolic function, up to 47% had PHT due to either PAH with increased CO (70%) or PVH with elevated LV filling pressure (30%). Most importantly, hyperthyroidism-related PHT was largely asymptomatic and reversible after restoration to a euthyroid state.

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  • Mild and usually asymptomatic pulmonary arterial hypertension has been reported in autoimmune hyperthyroidism, with an incidence of 36% to 65% in echocardiographic studies.

    “Mild and usually asymptomatic pulmonary arterial hypertension has been reported, especially in autoimmune hyperthyroidism, with an incidence ranging from 36% to 65% in echocardiographic studies(80).”

    From Thyroid Hormones and Cardiovascular Function and Diseases (2018) · cites this paper as [80]

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Authors
Siu, C.-W., Zhang, X.-H., Yung, C., Kung, A. W. C., Lau, C.-P., & Tse, H.-F.
Affiliations
Queen Mary Hospital (CN)
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2007-05
Volume
92
Issue
5
Pages
1736-1742
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jc.2006-1877
OpenAlex
W1985816798
Cited by
121
References
28
Citations by year
2026: 2 · 2025: 2 · 2024: 4 · 2023: 5 · 2022: 11 · 2021: 3 · 2020: 2 · 2019: 5 · 2018: 9 · 2017: 11 · 2016: 5 · 2015: 8 · 2014: 5 · 2013: 10 · 2012: 5
FWCI
7.49
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
  • The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Pulmonary Hypertension Research and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Keywords
hyperthyroidism, pulmonary hypertension, pulmonary arterial hypertension, pulmonary venous hypertension, hemodynamics, cardiac output, total vascular resistance, left ventricular filling pressure, diastolic function, antithyroid drug therapy, euthyroidism, prevalence, left ventricular systolic function, mitral annular velocity
MeSH terms
Adult, Blood Pressure, Carbimazole, Cardiac Output, Echocardiography, Female, Follow-Up Studies, Humans, Hypertension, Pulmonary, Hyperthyroidism, Male, Middle Aged, Propylthiouracil, Prospective Studies, Antithyroid Agents, Vascular Resistance, Echocardiography, Doppler, Ventricular Function, Left, Treatment Outcome

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