Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.
J Affect Disord. 2018 Oct 1;238:213-217. doi: 10.1016/j.jad.2018.05.034. Epub 2018 May 30.
To investigate long-term effects of adjunctive prophylactic treatment with supraphysiologic doses of levothyroxine (L-T4) on cardiovascular tolerability in 23 patients with treatment-refractory mood disorders.
Starting point for a comprehensive cardiovascular assessment in patients was the indication for long-term maintenance treatment with L-T4 (mean dose 463 mcg/day). Prospective longitudinal assessment of the cardiovascular risk profile included in addition to a physical examination and blood pressure measurement, several technical investigations: resting electrocardiogram, transthoracic echocardiogram, cardiac stress test, and holter electrocardiogram. Statistical analysis was performed by linear mixed effects models (LMM) for evaluation of longitudinal changes in various heart measures.
During the mean observational period of 20.4 months none of the heart measures reached statistical significance in change over time. None of the assessed cardiac parameters of each single patient was in a range predictive for cardiac dysfunction.
Small sample size, no technical cardiac investigations prior to L-T4 initiation, no patient control group with mood disorders who did not receive L-T4.
Results of this study indicated no increased risk for cardiovascular disorders during treatment with supraphysiologic L-T4 doses in patients with refractory mood disorders.
为了研究在 23 名治疗抵抗性情绪障碍患者中，辅助使用超生理剂量左甲状腺素（L-T4）预防性治疗对心血管耐受性的长期影响。
对患者进行全面心血管评估的起点是长期使用 L-T4 维持治疗的指征（平均剂量 463 mcg/天）。除了体检和血压测量外，前瞻性纵向评估心血管风险状况还包括多项技术检查：静息心电图、经胸超声心动图、心脏应激试验和动态心电图。通过线性混合效应模型（LMM）进行统计分析，以评估各种心脏指标的纵向变化。
在平均观察期 20.4 个月内，各种心脏指标的时间变化均无统计学意义。每个患者评估的心脏参数均未达到预测心脏功能障碍的范围。
样本量小，在开始 L-T4 治疗前没有进行技术心脏检查，没有未接受 L-T4 治疗的难治性情绪障碍患者对照组。
本研究结果表明，在难治性情绪障碍患者中使用超生理剂量 L-T4 治疗期间，心血管疾病的风险没有增加。
