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Cited by 57Thyroid Disorders and TreatmentsCardiovascular Function and Risk FactorsCardiac electrophysiology and arrhythmias

Effects of TSH-suppressive therapy on cardiac morphology and function: beneficial effects of the addition of beta-blockade on diastolic dysfunction

Gullu, S, Altuntas, F, Dincer, I, Erol, C, Kamel, N·2004·European Journal of Endocrinology
DOI 10.1530/eje.0.1500655
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Abstract

OBJECTIVE: To investigate the effects of long-term levothyroxine (LT4) suppressive therapy on the heart and the effects of beta-blockade on cardiac functions. DESIGN: Twelve female patients receiving LT4, selected from a group of patients with TSH levels of 0.1-0.4 microU/ml, were evaluated. The control group consisted of 11 healthy subjects and 12 patients with TSH levels <0.05 microU/ml. METHODS: Cardiac evaluation consisted of a 12-lead electrocardiogram and an echocardiographic study. Left ventricular mass index (LVMI), isovolumetric relaxation time (IVR), left ventricular end systolic (LVESD) and diastolic diameters, early (VE) and late (VA) diastolic flow velocities and fractional shortening were evaluated. Exercise capacity was assessed with a bicycle ergometer. Both work load and maximal exercise time were measured. Atenolol was given to the patient group at a dosage of 50 mg/day for 3 months and evaluations were repeated. RESULTS: On basal evaluations, LVMI (96+/-17 vs 78+/-21 g/m(2)) and IVR (101+/-9 vs 91+/-4 ms) were found to be increased in the patients taking LT4 (P<0.01). LVESD was also lower than controls (P<0.05). A decrease in VE and an increase in VA were also observed in the patients (P<0.01). IVR decreased after atenolol (92+/-10 vs 101+/-9 ms, P<0.05). LVMI decreased and VE and VA improved but did not reach statistical significance after beta-blockade. Baseline work load and maximal exercise duration were significantly lower in the patients and improvements were observed after atenolol treatment. CONCLUSIONS: These results indicated that cardiac dysfunction may occur even when TSH is suppressed to 0.1-0.4 microU/ml with LT4. beta-blockade improved the cardiac functions.

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  • Some studies suggest that cardioselective β-blockers or treatment of SHyper with ATDs may improve symptoms, heart rate and supraventricular arrhythmias in patients with grade 2 SHyper.

    “Some studies suggest that cardioselective β-blockers [47,48] or treatment of SHyper with ATDs [46,67] may improve symptoms, heart rate and supraventricular arrhythmias in patients with grade 2 SHyper.”

    From The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism (2015) · cites this paper as [48]

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Authors
Gullu, S., Altuntas, F., Dincer, I., Erol, C., & Kamel, N.
Affiliations
Ankara University (TR)
ORCID
Kamel, N
Venue
European Journal of Endocrinology
Publisher
Oxford University Press (OUP)
Published
2004-05-01
Volume
150
Issue
5
Pages
655-661
ISSN
  • 0804-4643 (ISSN-L)
  • 1479-683X
DOI
10.1530/eje.0.1500655
OpenAlex
W2111593555
Cited by
57
References
31
Citations by year
2025: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 2 · 2018: 4 · 2017: 2 · 2016: 2 · 2015: 4 · 2014: 2 · 2013: 6 · 2012: 5
FWCI
2.69
Type
journal article
Language
en
Open access
closed
Locations
  • European Journal of Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Keywords
TSH suppression, levothyroxine, beta-adrenergic blockade, atenolol, diastolic dysfunction, left ventricular mass, left ventricular hypertrophy, isovolumic relaxation time, exercise capacity, cardiac function, subclinical hyperthyroidism
MeSH terms
Adrenergic beta-Antagonists, Adult, Atenolol, Blood Flow Velocity, Coronary Circulation, Diastole, Echocardiography, Exercise Test, Female, Heart, Heart Rate, Humans, Middle Aged, Myocardial Contraction, Myocardium, Physical Endurance, Stroke Volume, Systole, Thyrotropin, Thyroxine

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