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Echocardiographic evolution of pulmonary hypertension in female patients with hyperthyroidism [Anatol J Cardiol]
Anatol J Cardiol. Ahead of Print: AJC-37096 | DOI: 10.14744/AnatolJCardiol.2018.37096  

Echocardiographic evolution of pulmonary hypertension in female patients with hyperthyroidism

Cristina Tudoran, Mariana Tudoran, Mihaela Vlad, Melania Balas, Gheorghe Nicusor Pop, Florina Parv
Department of Internal Medicine II, University of Medicine and Pharmacy Victor Babes, Timisoara, Romania

The objective of this study is to highlight the impact of increased cardiac output (CO) and/or pulmonary vascular resistance (PVR) on the occurrence and evolution of pulmonary hypertension (PH) in hyperthyroidism and to follow their evolution under therapy.
Methods: Our study group consisted of 142 women with hyperthyroidism of different severities and etiologies. We divided our patients into three groups: group A- overt hyperthyroidism, B- with recurrent disease and C subclinical forms. By means of echocardiography we determined the levels of echocardiographically estimated systolic pulmonary arterial pressure (eePAPs), CO and PVR before and at 3, 6 and 12 months after treatment with thyroid suppression therapy and beta-blockers.
Results: In our study group we documented PH of various severity in 73 patients (51.4%). Increased CO, induced mostly by hyperthyroidism specific tachycardia, was detected frequently in overt hyperthyroidism and also augmented PVR, documented in 43.66% of subjects with severe and recurrent forms.
For all patients with PH, we emphasized a strong correlation between eePAPs and PVR levels, (r=0,854, p˂0.0001) a moderate one with CO (r=0.437, p˂0.0001) and with the duration of hyperthyroidism (r=0.545, p˂0.0001).
Under therapy, CO normalized quickly and PVR decreased significantly in groups A and C. In group B the reduction was modest, still statistically significant.
Conclusions: The pathophysiological mechanisms responsible for the occurrence of PH are the elevation of CO and especially of PVR. While increased CO alleviates fast under therapy, elevated eePAPs and PVR persisted in reccurent cases, being responsible for the perpetuation of PH.

Keywords: pulmonary hypertension, hyperthyroidism, cardiac output, pulmonary vascular resistance

Corresponding Author: Mariana Tudoran, Romania

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