Çelik Semih, Uç Ziynet Alphan, Candan Özkan
Department of Internal Medicine, Faculty of Medicine, Usak University, Usak Training and Research Hospital, Usak, Turkey.
Department of Endocrinology and Metabolism, Faculty of Medicine, Usak University, Usak Training and Research Hospital, Usak, Turkey.
Endocr Res. 2025 Feb;50(1):28-35. doi: 10.1080/07435800.2024.2383669. Epub 2024 Jul 25.
The aim of this study was to investigate changes in heart rate variability (HRV) and QT dispersion (QTd) in patients with differentiated thyroid cancer at different TSH suppression levels.
The study included 125 DTC patients, who had been on TSH suppression treatment (TSHST) for at least 1 year. The patients were categorized into three groups: patients with TSH < 0.1 mIU/L (n:30), those with TSH 0.1 to 0.5 mIU/L (n:56), and those with TSH 0.5 to 2 mIU/L (n:39). The first two groups were classified as suppression groups, and the last as replacement (control) group. All patients underwent 12-lead electrocardiogram (ECG) recording and 24-hour rhythm holter echocardiography analysis.
The HRV results derived from a 24-hour rhythm holter did not exhibit any significant difference ( < 0.05). In dispersion evaluations, the QTd was significantly longer in the suppression groups (groups 1 and 2), than in the replacement group (group 3) ( < 0.001 and p:0.002, respectively). The same was found for corrected QT dispersion (QTcd) ( < 0.001 and p: 0.008, respectively). In multivariate linear regression analysis, TSH was found to affect QTd (β = -0.299; = 0.002) and QTcd (β = -0.300; = 0.002) values independently.
In this study, it was shown that in patients with DTC receiving TSHST, QT dispersion prolonged as the TSH suppression level increased. Especially in high-risk DTC patients, evaluation of QTd may be useful in terms of evaluating cardiovascular risk and regulating TSHST level.
本研究旨在调查不同促甲状腺激素（TSH）抑制水平的分化型甲状腺癌患者的心率变异性（HRV）和QT离散度（QTd）的变化。
该研究纳入了125例接受TSH抑制治疗（TSHST）至少1年的分化型甲状腺癌患者。患者被分为三组：TSH<0.1 mIU/L的患者（n = 30）、TSH为0.1至0.5 mIU/L的患者（n = 56）以及TSH为0.5至2 mIU/L的患者（n = 39）。前两组被归类为抑制组，最后一组为替代（对照）组。所有患者均接受了12导联心电图（ECG）记录和24小时动态心电图超声心动图分析。
24小时动态心电图得出的HRV结果未显示出任何显著差异（<0.05）。在离散度评估中，抑制组（第1组和第2组）的QTd明显长于替代组（第3组）（分别为<0.001和p = 0.002）。校正QT离散度（QTcd）也有相同结果（分别为<0.001和p = 0.008）。在多变量线性回归分析中，发现TSH独立影响QTd（β = -0.299； = 0.002）和QTcd（β = -0.300； = 0.002）值。
本研究表明，在接受TSHST的分化型甲状腺癌患者中，QT离散度随TSH抑制水平的升高而延长。特别是在高危分化型甲状腺癌患者中，评估QTd对于评估心血管风险和调节TSHST水平可能是有用的。
