Brusseau Valentin, Tauveron Igor, Bagheri Reza, Ugbolue Ukadike Chris, Magnon Valentin, Bouillon-Minois Jean-Baptiste, Navel Valentin, Dutheil Frederic
Endocrinology Diabetology and Metabolic Diseases, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, F-63000 Clermont-Ferrand, France.
Institut Génétique, Reproduction & Développement (iGReD), CNRS, INSERM, University of Clermont Auvergne, F-63000 Clermont-Ferrand, France.
Biomedicines. 2022 Aug 16;10(8):1982. doi: 10.3390/biomedicines10081982.
The reversibility of HRV abnormalities in hyperthyroidism remains contradictory. The design of this study involves conducting a systematic review and meta-analysis on the effect of antithyroid treatments on HRV in hyperthyroidism. PubMed, Cochrane, Embase, and Google Scholar were searched until 4 April 2022. Multiple reviewers selected articles reporting HRV parameters in treated and untreated hyperthyroidism. Independent data extraction by multiple observers was stratified by degree of hyperthyroidism for each HRV parameter: RR intervals, SDNN (standard deviation of RR intervals), RMSSD (square root of the mean difference of successive RR intervals), pNN50 (percentage of RR intervals with >50 ms of variation), total power (TP), LFnu (low-frequency normalized unit) and HFnu (high-frequency), VLF (very low-frequency), and LF/HF ratio. We included 11 studies for a total of 471 treated hyperthyroid patients, 495 untreated hyperthyroid patients, and 781 healthy controls. After treatment, there was an increase in RR, SDNN, RMSSD, pNN50, TP, HFnu, and VLF and a decrease in LFnu and LF/HF ratio (p < 0.01). Overt hyperthyroidism showed similar results, in contrast to subclinical hyperthyroidism. Compared with controls, some HRV parameter abnormalities persist in treated hyperthyroid patients (p < 0.05) with lower SDNN, LFnu, and higher HFnu, without significant difference in other parameters. We showed a partial reversibility of HRV abnormalities following treatment of overt hyperthyroidism. The improvement in HRV may translate the clinical cardiovascular benefits of treatments in hyperthyroidism and may help to follow the evolution of the cardiovascular morbidity.
甲状腺功能亢进症中心率变异性（HRV）异常的可逆性仍然存在争议。本研究的设计包括对甲状腺功能亢进症中抗甲状腺治疗对HRV的影响进行系统评价和荟萃分析。检索了PubMed、Cochrane、Embase和谷歌学术，截至2022年4月4日。多名评审员筛选了报告治疗和未治疗的甲状腺功能亢进症中HRV参数的文章。由多名观察者进行的独立数据提取，根据每个HRV参数（RR间期、RR间期标准差（SDNN）、相邻RR间期差值的均方根（RMSSD）、RR间期变异性>50 ms的百分比（pNN50）、总功率（TP）、低频标准化单位（LFnu）和高频（HFnu）、极低频（VLF）以及LF/HF比值）的甲状腺功能亢进程度进行分层。我们纳入了11项研究，共471例接受治疗的甲状腺功能亢进症患者、495例未治疗的甲状腺功能亢进症患者和781例健康对照。治疗后，RR、SDNN、RMSSD、pNN50、TP、HFnu和VLF增加，LFnu和LF/HF比值降低（p<0.01）。与亚临床甲状腺功能亢进症相比，显性甲状腺功能亢进症显示出相似的结果。与对照组相比，治疗后的甲状腺功能亢进症患者中一些HRV参数异常仍然存在（p<0.05），SDNN、LFnu较低，HFnu较高，其他参数无显著差异。我们显示显性甲状腺功能亢进症治疗后HRV异常有部分可逆性。HRV的改善可能转化为甲状腺功能亢进症治疗的临床心血管益处，并可能有助于追踪心血管疾病发病率的演变。
