Tạp chí Tim mạch học Việt Nam

Article detail

Article detail description

Home
NGHIÊN CỨU LÂM SÀNG Issue: Số 110 BỆNH RỐI LOẠN NHỊP TIM

Electrocardiogram characteristics and heart rate variables in patients with primary hypothyroidism

Nguyễn Thị Linh: Bệnh viện Thanh Nhàn; Phạm Minh Tuấn: Viện Tim mạch Việt Nam, Bệnh viện Bạch Mai; Phạm Thị Hồng Thi: Viện Tim mạch Việt Nam, Bệnh viện Bạch Mai; Đỗ Thị Thu Hương: Trường Đại học Y Dược Thái Bình; Nguyễn Ngọc Quang: Trường Đại học Y Hà Nội;
Published: July 30, 2024
Views: 201

Abstract

Background: Hypothyroidism is a common endocrine disease and is also a factor that increases the risk of cardiovascular diseases. One of the main problems of thyroid disease in general and hypothyroidism in particular is causing cardiac arrhythmias, usually supraventricular arrhythmias, and the mechanism may be due to imbalance in the autonomic nervous system.

Objective: Describe the electrocardiogram characteristics and heart rate variability in patients with primary hypothyroidism and explore the relationship between electrocardiogram changes and some clinical and subclinical symptoms of hypothyroidism patients.

Methods: Cross-sectional description of 40 patients. Selection criteria are patients with a confirmed diagnosis of primary hypothyroidism. Characteristics of heart rate variability were assessed on 12-lead electrocardiogram and 24-hour Holter electrocardiogram.

Results: The study had the majority of women (70%), average age was 54 ± 13 years old, the age group with the highest rate was 40-60 years old, the rate of overweight and obesity was 52.5%. The most common clinical symptoms are muscle and joint pain (67.5%), dry skin, hair loss (60%), fatigue, and drowsiness (50%). On electrocardiogram images, 100% were in sinus rhythm, 27.5% had sinus bradycardia. There was one case of premature ventricular complexes, one case of 1st degree avioventricular block and three cases of right bundle branch block. On Holter ECG: 5% had sinus bradycardia, 80% had atrial premature beats, 20% had ventricular premature beats, 2,5% had 1st degree avioventricular block. There were no differences in heart rate variability among age groups, BMI and TSH index. There were no differences in mean, highest, and lowest heart rates between age, sex, BMI, and TSH groups.

Conclusions: Both overt and subclinical thyroid disorders were associated with significant changes in important ECG parameters.

References

1.
Cacciatori V, Gemma ML, Bellavere F, et al. Power spectral analysis of heart rate in hypothyroidism. Eur J Endocrinol. 2000;143(3):327-333. doi:10.1530/eje.0.1430327
2.
Kweon KH, Park BH, Cho CG. The effects of L-thyroxine treatment on QT dispersion in primary hypothyroidism. J Korean Med Sci. 2007;22(1):114-116. doi:10.3346/jkms.2007.22.1.114
3.
Sarma JS, Venkataraman K, Nicod P, et al. Circadian rhythmicity of rate-normalized QT interval in hypothyroidism and its significance for development of class III antiarrhythmic agents. Am J Cardiol. 1990;66(12):959-963. doi:10.1016/0002-9149(90)90933-r
4.
Burack R, Edwards RH, Green M, et al. The response to exercise before and after treatment of myxedema with thyroxine. J Pharmacol Exp Ther. 1971;176(1):212-219.
5.
Fredlund BO, Olsson SB. Long QT interval and ventricular tachycardia of "torsade de pointe" type in hypothyroidism. Acta Med Scand. 1983;213(3):231-235. doi:10.1111/j.0954-6820.1983.tb03724.x
6.
Nathaniel C, Caleb L, Azrin MA. QTc prolongation in hypothyroidism. J Am Coll Cardiol. 1994;23:36A.
7.
Altun A, Altun G, Ozkan B, et al. The relationship between ventricular repolarization and thyroid stimulating hormone. Ann Noninvasive Electrocardiogr. 1998;3:19.
8.
Kannan L, Kotus-Bart J, Amanullah A. Prevalence of Cardiac Arrhythmias in Hypothyroid and Euthyroid Patients. Horm Metab Res. 2017;49(6):430-433. doi:10.1055/s-0043-105275
9.
Galetta F, Franzoni F, Fallahi P, et al. Heart rate variability and QT dispersion in patients with subclinical hypothyroidism. Biomed Pharmacother. 2006;60(8):425-430. doi:10.1016/j.biopha.2006.07.009

Files

Article Views201
Document Views0
Downloads0
Section NGHIÊN CỨU LÂM SÀNG
Issue Số 110
Category BỆNH RỐI LOẠN NHỊP TIM