Král J, Hradec J, Limanová J
IIIrd Department of Internal Medicine, Charles University 1st School of Medicine, Prague, Czechoslovakia.
Cor Vasa. 1992;34(2):108-14.
The paper examines the basic pathophysiologic mechanisms playing a role in the development of cardiovascular changes on thyroid hyper- and hypofunction. The haemodynamic changes typically associated with increased and decreased secretion of thyroid hormones are described and compared. Using echocardiography, the haemodynamics changes are documented in 12 patients with hyperthyroidism and 19 patients with myxoedema prior to thyrostatic and substitution therapy. Characteristic findings in florid hyperthyroidism include a significant rise in left ventricular end-diastolic volume as well as increases in stroke volume (SV) and cardiac index (CI). Mean velocity of circumferential fibre shortening (mVCF) is also significantly increased. Left ventricular myocardial weight shows a tendency towards an increase. Hypothyreosis is primarily associated with decreases in SV and CI; mVCF also declines. The paper underlines the importance of causative therapy as the above haemodynamics changes are fully reversible on attaining normal thyroid function.
本文探讨了甲状腺功能亢进和减退时心血管变化发生发展过程中起作用的基本病理生理机制。描述并比较了通常与甲状腺激素分泌增加和减少相关的血流动力学变化。采用超声心动图，对12例甲状腺功能亢进患者和19例黏液性水肿患者在进行抗甲状腺和替代治疗前的血流动力学变化进行了记录。典型的甲状腺功能亢进表现为左心室舒张末期容积显著增加，同时每搏输出量（SV）和心脏指数（CI）增加。圆周纤维缩短平均速度（mVCF）也显著增加。左心室心肌重量有增加趋势。甲状腺功能减退主要与SV和CI降低有关；mVCF也下降。本文强调了病因治疗的重要性，因为上述血流动力学变化在甲状腺功能恢复正常时可完全逆转。
