Department of Medicine OCentre of Endocrinology and Metabolism, Herlev University Hospital, Herlev Ringvej 75, Herlev DK-2730, DenmarkDepartment of Clinical Physiology and Nuclear MedicineFrederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, DenmarkDepartment of Clinical PhysiologyNuclear Medicine and PET, Rigshospitalet, Blegdamsvej 9, København Ø, DenmarkFaculty of Health SciencesUniversity of Copenhagen, Blegdamsvej 3B, 2200 København N, DenmarkCenter for Functional and Diagnostic Imaging and ResearchHvidovre University Hospital, Kettegård Allé 30, 2650 Hvidovre, Denmark
Department of Medicine OCentre of Endocrinology and Metabolism, Herlev University Hospital, Herlev Ringvej 75, Herlev DK-2730, DenmarkDepartment of Clinical Physiology and Nuclear MedicineFrederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, DenmarkDepartment of Clinical PhysiologyNuclear Medicine and PET, Rigshospitalet, Blegdamsvej 9, København Ø, DenmarkFaculty of Health SciencesUniversity of Copenhagen, Blegdamsvej 3B, 2200 København N, DenmarkCenter for Functional and Diagnostic Imaging and ResearchHvidovre University Hospital, Kettegård Allé 30, 2650 Hvidovre, Denmark.
Endocr Connect. 2015 Mar;4(1):37-42. doi: 10.1530/EC-14-0137. Epub 2015 Jan 7.
The aim of this study was to investigate structure and function of the heart in subclinical hyperthyroidism (SH) before and after obtaining euthyroidism by radioactive iodine treatment, using high precision and observer-independent magnetic resonance imaging (MRI) technology.
Cardiac MRI was performed before and after euthyroidism was obtained by radioactive iodine treatment in 12 otherwise healthy patients (11 women and one man, mean age 59 years, range 44-71 years) with a nodular goiter and SH, and compared with eight healthy controls investigated at baseline. Cardiac data were expressed as an index, as per body surface area, except for heart rate (HR) and ejection fraction.
Post-treatment cardiac MRI was performed in median 139 days after a normalized serum TSH value had been recorded. During treatment, serum TSH increased from (median (range)) 0.01 (0.01-0.09) to 0.88 (0.27-3.99) mU/l. Patients with untreated SH had increased resting HR (P<0.01) as well as cardiac index (cardiac output as per body surface area) (P<0.01) compared with controls. Obtaining euthyroidism resulted in a significant decrease in left ventricular mass index (LVMI) of 2.7 g/m(2) (P=0.034), in HR of 8 bpm (P=0.001), and in cardiac index of 0.24 l/min per m(2) (P=0.017).
Normalization of thyroid function by radioactive iodine treatment of SH resulted in significant reductions in clinically important heart parameters such as LVMI, HR, and cardiac index. SH should be regarded as a condition in which aggressive treatment should be considered to protect cardiac function.
本研究旨在使用高精度、观察者独立的磁共振成像（MRI）技术，探讨亚临床甲状腺功能亢进（SH）在放射性碘治疗获得甲状腺功能正常前后的心脏结构和功能。
对 12 例患有结节性甲状腺肿和 SH 的健康患者（11 名女性和 1 名男性，平均年龄 59 岁，范围 44-71 岁）进行放射性碘治疗，在获得甲状腺功能正常前后进行心脏 MRI，并与 8 名健康对照组进行比较。心脏数据表示为指数，按体表面积表示，除心率（HR）和射血分数外。
在血清 TSH 值正常记录后中位数 139 天进行了治疗后心脏 MRI。治疗期间，血清 TSH 从（中位数（范围））0.01（0.01-0.09）增加到 0.88（0.27-3.99）mU/l。未经治疗的 SH 患者的静息 HR（P<0.01）和心脏指数（体表面积的心输出量）（P<0.01）均高于对照组。获得甲状腺功能正常导致左心室质量指数（LVMI）降低 2.7 g/m(2)（P=0.034），HR 降低 8 次/分钟（P=0.001），心脏指数降低 0.24 l/min/m(2)（P=0.017）。
放射性碘治疗 SH 甲状腺功能正常导致 LVMI、HR 和心脏指数等重要临床心脏参数显著降低。SH 应被视为一种需要积极治疗以保护心脏功能的疾病。
