Impaired cardiac reserve and exercise capacity in patients receiving long-term thyrotropin suppressive therapy with levothyroxine (416 views)
J Clin Endocrinol Metab (ISSN: 0021-972x), 1996 Dec; 81(12): 4224-4228.
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Paper type: Journal Article,
Impact factor: 4.575, 5-year impact factor: 6.004
Url: http://www.scopus.com/inward/record.url?eid=2-s2.0-0029802333&partnerID=40&md5=04d0d502247a0ed2458edb7b67e55668
Keywords: Beta Adrenergic Receptor Blocking Agent, Bisoprolol, Levothyroxine, Liothyronine, Thyrotropin, Adult, Article, Bicycle Ergometry, Clinical Article, Clinical Trial, Controlled Clinical Trial, Controlled Study, Exercise Tolerance, Female, Goiter, Heart Left Ventricle Function, Human, Long Term Care, Priority Journal, Scintiangiography, Thyroid Carcinoma, Thyroid Disease, Adrenergic Beta-Antagonists, Middle Aged, Ventricular Function,
Affiliations:
Depts. Int. Med., Endocrinol., N., Univ. Federico II Medical School, Naples, Italy
Medicina Interna, Via Pansini 5, 80131 Naples, Italy
References:
Not available.
J Clin Endocrinol Metab (ISSN: 0021-972x), 1996 Dec; 81(12): 4224-4228.
Export to BibTeX Export to EndNote
Paper type: Journal Article,
Impact factor: 4.575, 5-year impact factor: 6.004
Url: http://www.scopus.com/inward/record.url?eid=2-s2.0-0029802333&partnerID=40&md5=04d0d502247a0ed2458edb7b67e55668
Keywords: Beta Adrenergic Receptor Blocking Agent, Bisoprolol, Levothyroxine, Liothyronine, Thyrotropin, Adult, Article, Bicycle Ergometry, Clinical Article, Clinical Trial, Controlled Clinical Trial, Controlled Study, Exercise Tolerance, Female, Goiter, Heart Left Ventricle Function, Human, Long Term Care, Priority Journal, Scintiangiography, Thyroid Carcinoma, Thyroid Disease, Adrenergic Beta-Antagonists, Middle Aged, Ventricular Function,
Affiliations:
Depts. Int. Med., Endocrinol., N., Univ. Federico II Medical School, Naples, Italy
Medicina Interna, Via Pansini 5, 80131 Naples, Italy
References:
Not available.
Impaired cardiac reserve and exercise capacity in patients receiving long-term thyrotropin suppressive therapy with levothyroxine
To assess cardiac function and exercise tolerance in patients receiving long term TSH-suppressive therapy with levothyroxine (L-T4), we studied maximal exercise capacity with a bicycle ergometer and left ventricular function at rest and during physical exercise by radionuclide angiography. The evaluation was performed in 10 patients receiving L-T4 therapy (2.31 ± 0.13 μg/kg) for 5-9 yr, presenting with effort dyspnea and symptoms of adrenergic overactivity, and 10 matched control subjects. The patients were reassessed after 4 months of administration of the selective β-adrenergic blocker bisoprolol (4.25 ± 0.4 mg/day); L-T4 therapy remained unchanged. The results showed that at rest, left ventricular diastolic filling was impaired in the patients (P < 0.05), whereas systolic function was unaltered. During submaximal physical exercise, left ventricular ejection fraction increased in the controls from 58 ± 2% to 65 ± 2% (P < 0.001), whereas in the patients it fell from 63 ± 2% to 53 ± 2% (P < 0.01), mainly because of increased end-systolic left ventricular volume (P < 0.05). Exercise capacity was markedly reduced in the patients in terms of both peak workload (P < 0.001) and exercise duration (P < 0.001). β-Adrenergic blockade prevented both the fall in ejection fraction and the increase in end-systolic volume during exercise, and improved exercise tolerance. In conclusion, our data show that long term TSH-suppressive therapy with L-T4 is not as harmless as believed, because it may cause marked impairment of cardiac functional reserve and physical exercise capacity. Administration of a β-blocking drug for 4 months caused significant improvement of cardiac performance and exercise tolerance.
To assess cardiac function and exercise tolerance in patients receiving long term TSH-suppressive therapy with levothyroxine (L-T4), we studied maximal exercise capacity with a bicycle ergometer and left ventricular function at rest and during physical exercise by radionuclide angiography. The evaluation was performed in 10 patients receiving L-T4 therapy (2.31 ± 0.13 μg/kg) for 5-9 yr, presenting with effort dyspnea and symptoms of adrenergic overactivity, and 10 matched control subjects. The patients were reassessed after 4 months of administration of the selective β-adrenergic blocker bisoprolol (4.25 ± 0.4 mg/day); L-T4 therapy remained unchanged. The results showed that at rest, left ventricular diastolic filling was impaired in the patients (P < 0.05), whereas systolic function was unaltered. During submaximal physical exercise, left ventricular ejection fraction increased in the controls from 58 ± 2% to 65 ± 2% (P < 0.001), whereas in the patients it fell from 63 ± 2% to 53 ± 2% (P < 0.01), mainly because of increased end-systolic left ventricular volume (P < 0.05). Exercise capacity was markedly reduced in the patients in terms of both peak workload (P < 0.001) and exercise duration (P < 0.001). β-Adrenergic blockade prevented both the fall in ejection fraction and the increase in end-systolic volume during exercise, and improved exercise tolerance. In conclusion, our data show that long term TSH-suppressive therapy with L-T4 is not as harmless as believed, because it may cause marked impairment of cardiac functional reserve and physical exercise capacity. Administration of a β-blocking drug for 4 months caused significant improvement of cardiac performance and exercise tolerance.
Impaired cardiac reserve and exercise capacity in patients receiving long-term thyrotropin suppressive therapy with levothyroxine
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Impaired cardiac reserve and exercise capacity in patients receiving long-term thyrotropin suppressive therapy with levothyroxine
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Impact Factor: 4.991
View Export to BibTeX Export to EndNote
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View Export to BibTeX Export to EndNote
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Impact Factor: 6.02
View Export to BibTeX Export to EndNote
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Impact Factor: 6.02
View Export to BibTeX Export to EndNote
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View Export to BibTeX Export to EndNote
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Impact Factor: 5.873
View Export to BibTeX Export to EndNote
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Impact Factor: 5.805
View Export to BibTeX Export to EndNote
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Impact Factor: 1.681
View Export to BibTeX Export to EndNote
Greco AM, de Franciscis P, Bozza P, Salvatore M
Thyroid function and lipid metabolism in rats treated with lithium and cholesterol deficient Nath diet (812 views)
Boll Soc Ital Biol Sper (ISSN: 0037-8771), 1979 Dec 30; 55(24): 2589-2595.
Impact Factor: 0
View Export to BibTeX Export to EndNote
25 Records (24 excluding Abstracts).
Total impact factor: 95.283 (93.395 excluding Abstracts).
Total 5 year impact factor: 83.62 (81.489 excluding Abstracts).
Total impact factor: 95.283 (93.395 excluding Abstracts).
Total 5 year impact factor: 83.62 (81.489 excluding Abstracts).
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