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在埃塞俄比亚亚的斯亚贝巴提克里安贝萨专科医院接受随访的甲状腺功能亢进症患者中心脏异常的程度及其相关因素。

Magnitude of cardiac abnormality and its associated factors among hyperthyroidism patients on follow-up at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.

机构信息

Department of Internal medicine, School of Medicine, College of Health Sciences, Addis Abeba University, Addis Abeba, Ethiopia.

Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

出版信息

BMC Cardiovasc Disord. 2024 Oct 14;24(1):558. doi: 10.1186/s12872-024-04212-3.

Abstract

BACKGROUND

Thyroid hormones have an effect on every organ system, in particular, the heart responds to minimal changes in serum thyroid hormone level. Thyroid hormone causes a lot of changes in the cardiovascular system, such as increased heart rate, contractility, systolic hypertension, changes in peripheral vascular resistance, atrial fibrillation (AF), and hypercoagulability from the direct effect of thyroid hormone on cardiac myocyte and /or due to increased metabolic state. However, the magnitude of such heart abnormalities and its associated factors were not well studied in Ethiopia.

OBJECTIVE

To determine the magnitude of cardiac abnormality and its associated factors among hyperthyroidism patients on follow-up at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia, 2022.

METHODS

An institution-based cross-sectional study was carried out among 318 hyperthyroid patients who were on follow-up at the endocrine clinic of TASH, Addis Ababa, Ethiopia from June to October 2022. The data were collected using a pretested structured interviewer administered questionnaire. The data were entered into the computer using EpiData version 3.1 and analyzed using SPSS version 25 software. Bivariable and multivariable logistic regression models were fitted to determine the association between the independent and dependent variables. Adjusted odds ratio with its 95% confidence interval and p-value < 0.05 were used to declare the presence and strength of statistically significant associations.

RESULT

In this study a total of 318 hyperthyroid patients were participated, most (90.9%) of them were females. The overall prevalence of heart failure among hyperthyroid patients was 17.0% (95% CI = 13.0, 21.6). More than half (52.7%) and one third (33.2%) of the participants showed abnormal electrocardiographic and echocardiographic findings respectively. Marital status (not married) [AOR = 2.37, 95% CI (1.03, 5.44)], pattern of hyperthyroidism [AOR = 13.09, 95% CI (4.70, 36.41)], being Asthmatic [AOR = 7.63, 95% CI (1.55, 37.52)], type of medication [AOR = 3.49, 95% CI (1.11, 11.02)] and duration of treatment [AOR = 4.95, 95% CI (2.05,11.99)] were significantly associated with cardiac abnormality.

CONCLUSION

A significant portion of hyperthyroid patients overburdened by cardiac abnormalities. Being unmarried, overt hyperthyroid, Asthmatic, long stay on treatment and type of treatment were significantly associated with cardiac abnormality. Hence, attention should be given for cardiac abnormalities while treating hyperthyroid patients.

摘要

背景

甲状腺激素对每个器官系统都有影响,特别是心脏对血清甲状腺激素水平的微小变化有反应。甲状腺激素会导致心血管系统发生许多变化,例如心率加快、收缩力增强、收缩期高血压、外周血管阻力变化、心房颤动 (AF) 和由于甲状腺激素对心肌细胞的直接作用或由于代谢状态增加而导致的高凝状态。然而,在埃塞俄比亚,这种心脏异常的程度及其相关因素尚未得到很好的研究。

目的

在 2022 年,在亚的斯亚贝巴提克里安巴萨专科医院(TASH)接受随访的甲状腺功能亢进症患者中,确定心脏异常的程度及其相关因素。

方法

这是一项在 2022 年 6 月至 10 月期间在 TASH 内分泌科接受随访的 318 名甲状腺功能亢进症患者中进行的基于机构的横断面研究。使用经过预测试的访谈员管理问卷收集数据。数据使用 EpiData 版本 3.1 输入计算机,并使用 SPSS 版本 25 软件进行分析。使用双变量和多变量逻辑回归模型来确定独立和因变量之间的关联。使用调整后的优势比及其 95%置信区间和 p 值<0.05 来确定统计学上显著关联的存在和强度。

结果

在这项研究中,共有 318 名甲状腺功能亢进症患者参与,其中大多数(90.9%)为女性。甲状腺功能亢进症患者心力衰竭的总体患病率为 17.0%(95%CI=13.0,21.6)。超过一半(52.7%)和三分之一(33.2%)的参与者分别显示出异常心电图和超声心动图结果。婚姻状况(未婚)[调整后的优势比(AOR)=2.37,95%置信区间(CI)(1.03,5.44)]、甲状腺功能亢进症类型(AOR=13.09,95%CI(4.70,36.41)]、哮喘(AOR=7.63,95%CI(1.55,37.52)]、药物类型(AOR=3.49,95%CI(1.11,11.02)]和治疗持续时间(AOR=4.95,95%CI(2.05,11.99)]与心脏异常显著相关。

结论

相当一部分甲状腺功能亢进症患者心脏负担过重。未婚、显性甲状腺功能亢进症、哮喘、长期治疗和治疗类型与心脏异常显著相关。因此,在治疗甲状腺功能亢进症患者时,应注意心脏异常。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5ba/11475159/9e7b839385ee/12872_2024_4212_Figa_HTML.jpg

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