Comparison of 24-hour electrocardiogram parameters in patients with graves’ disease before and after anti-thyroid therapy
Endocrine, Metabolic and Immune Disorders - Drug Targets, vol.21, no.1, pp.183-191, 2021 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 21 Issue: 1
- Publication Date: 2021
- Doi Number: 10.2174/1871530320666200729145100
- Journal Name: Endocrine, Metabolic and Immune Disorders - Drug Targets
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Biotechnology Research Abstracts, Chemical Abstracts Core, EMBASE, MEDLINE
- Page Numbers: pp.183-191
- Keywords: Anti-thyroid therapy, Arrhythmia, Electrocardiogram, Graves’ Disease, Hyperthyroidism, Thyrotoxicosis
- Hatay Mustafa Kemal University Affiliated: Yes
Abstract
Background: We aimed prospectively to investigate the laboratory and electrocardiographic parameters (heart rate, QRS, QT, QTc, Tpe, Tpe/QTc, and arrhythmia prevalence) in patients with Graves’ disease before and after antithyroid therapy. Methods: Seventy-one patients (48 female, and 23 male), of age between 18-50 years (mean±SD: 36.48±12.20) with GD were included in the study. Patients were treated with antithyroid therapy (thioamides and/or surgical therapy) to maintain euthyroid status. Patients were examined in terms of electrocardiographic parameters before and after the treatment. Results: Mean TSH, free thyroxin (fT4), and tri-iodothyrionine (fT3) levels of all patients were 0.005±0.21, 3.27± 1.81, 11.42±7.44, respectively. While 9 patients (group 2) underwent surgical ther-apy, had suspicious malignant nodule or large goiter, and unresponsiveness to medical treatment; the other patients (n=62, group 1) were treated with medical therapy. Patients with surgical therapy had more increased serum fT4 (p=0.045), anti-thyroglobulin value (p=0.018) and more severe graves orbi-topathy (n=0.051) before treatment when compared to a medical therapy group. Baseline Tpe duration and baseline Tpe/QTc ratio and frequency of supraventricular ectopic beats were found to be signifi-cantly higher in group 2 when compared to group 1 (p=0.00, p=0.005). Otherwise, the baseline mean heart rate, QRS duration, QTc values of both groups were similar. Although the patients came at their euthyroid status, group 2 patients still suffered from more sustained supraventricular ectopics beats than group 1. Conclusion: Distinct from the medical treatment group, surgical treatment group with euthyroidism for at least 3 months still suffered from an arrhythmia (Tpe, Tpe/QTc, supraventricular and ventricular ectopic beats).