Findikli Hüseyin Avni, Tutak Ayşe Şahin, Aydin Hakan
Department of Internal Medicine, Kahramanmaraş Necip Fazıl City Hospital, Turkey.
Department of Internal Medicine, Adıyaman University, Turkey.
Rom J Intern Med. 2019 Jun 1;57(2):175-180. doi: 10.2478/rjim-2018-0042.
Changes in thyroid hormone level can affect the cardiovascular system. The aim of this study was to show how the Tpeak -Tend (Tpe) interval, which is a new marker of ventricular arrythmia, is affected in patients who have become euthyroid following Levothyroxine treatment for hypothyroidism, as this has not been examined previously in literature.
This, cross-sectional study included a total of 119 females aged 18-45 years, separated into 3 groups as hypothyroid, euthyroid and control groups. For evaluation of the QTc and Tpe intervals, examination on precordial V5 lead was made of all the ECGs taken routinely on presentation of the patients.
The Tpe and QTc intervals of the hypothyroid group were determined to be significantly prolonged compared to those of the euthyroid and control groups (p < 0.001) and the values of the euthyroid and control groups were similar. A positive correlation was determined between TSH levels and Tpe and QTc intervals. Tpe interval AUC = 0.801 (%95 CI: 0.719 - 0.884) was higher than that of QTc AUC = 0.689 (%95 CI: 0.591 - 0.786).
The Tpe duration was evaluated in respect of the risk of arrythmia in hypothyroid patients. In patients who had become euthyroid, the Tpe interval was found to be similar to that of healthy individuals and was more predictive than QTc. In the light of these findings it can be recommended that measurement of the Tpe interval should be preferred to QTc as a marker of the arrythmogenic effect in hypothyroid patients.
甲状腺激素水平的变化会影响心血管系统。本研究的目的是表明,作为室性心律失常新标志物的Tpeak - Tend(Tpe)间期,在因甲状腺功能减退接受左甲状腺素治疗后甲状腺功能恢复正常的患者中会受到怎样的影响,因为此前文献中尚未对此进行过研究。
这项横断面研究共纳入了119名年龄在18至45岁之间的女性,分为甲状腺功能减退组、甲状腺功能正常组和对照组。为评估QTc和Tpe间期,对患者就诊时常规采集的所有心电图进行胸前V5导联检查。
与甲状腺功能正常组和对照组相比,甲状腺功能减退组的Tpe和QTc间期明显延长(p < 0.001),且甲状腺功能正常组和对照组的值相似。TSH水平与Tpe和QTc间期之间存在正相关。Tpe间期AUC = 0.801(%95 CI:0.719 - 0.884)高于QTc AUC = 0.689(%95 CI:0.591 - 0.786)。
对甲状腺功能减退患者心律失常风险评估了Tpe持续时间。在甲状腺功能恢复正常的患者中,发现Tpe间期与健康个体相似,且比QTc更具预测性。根据这些发现,建议在甲状腺功能减退患者中,应优先选择测量Tpe间期而非QTc作为心律失常效应的标志物。