Research Article
BibTex RIS Cite
Year 2022, Volume: 12 Issue: 3, 247 - 251, 15.12.2022

Abstract

References

  • 1. Klein I, Danzi S. Thyroid Disease and the Heart. Curr Probl Cardiol 2016;41:65–92.
  • 2. I, K. Endocrine disorders and cardiovascular disease. In: Zipes DP, L.P., Bonow RO, Braunwald E, editors. Braunwald’s heart disease: A textbook of cardiovascular medicine. Philadelphia; 2005:2056–63.
  • 3. Selmer C, Olesen JB, Hansen ML, von Kappelgaard LM, Madsen JC, Hansen PR et al. Subclinical and overt thyroid dysfunction and risk of all-cause mortality and cardiovascular events: a large population study. J Clin Endocrinol Metab 2014;99:2372–82.
  • 4. Vanderpump MP, Tunbridge WM, French JM, Appleton D, Bates D, Clark F, Grimley Evans J et al. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey. Clin Endocrinol (Oxf) 1995;43:55–68.
  • 5. Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch Intern Med 2000;160:526–34.
  • 6. Donangelo, I. & Braunstein, G.D. Update on subclinical hyperthyroidism. Am Fam Physician 2011;83:933–8.
  • 7. Alexander B, Tse G, Martinez-Selles M, Baranchuk. Atrial Conduction Disorders. Curr Cardiol Rev 2021;17:68–73.
  • 8. Miceli F, Presta V, Citoni B, Canichella F, Figliuzzi I, Ferrucci A et al. Conventional and new electrocardiographic criteria for hypertension-mediated cardiac organ damage: A narrative review. J Clin Hypertens (Greenwich) 2019;21:1863–71.
  • 9. Ajibare AO, Olabode OP, Fagbemiro EY, Akinlade OM, Akintunde AA, Akinpelu OO et al. Assessment of Ventricular Repolarization in Sickle Cell Anemia Patients: The Role of QTc Interval, Tp-e Interval and Tp-e/QTc Ratio and Its Gender Implication. Vasc Health Risk Manag 2020;16:525–33.
  • 10. Shafi S, Saleem M, Anjum R, Abdullah W, Shafi T. ECG Abnormalities In Patients With Chronic Kidney Disease. J Ayub Med Coll Abbottabad. 2017;29(1):61–4.
  • 11. Kopeć G, Tyrka A, Miszalski-Jamka T, Sobień M, Waligóra M, Brózda M et al. Electrocardiogram for the diagnosis of right ventricular hypertrophy and dilation in idiopathic pulmonary arterial hypertension. Circ J. 2012;76(7):1744–9.
  • 12. Alter P, Watz H, Kahnert K, Rabe KF, Biertz F, Fischer R et al. Effects of airway obstruction and hyperinflation on electrocardiographic axes in COPD. Respir Res 2019;20:61.
  • 13. Li Y, Shah AJ, Soliman EZ. Effect of electrocardiographic P-wave axis on mortality. Am J Cardiol. 2014;113(2):372–6.
  • 14. Auer J, Scheibner P, Mische T, Langsteger W, Eber O, Eber B et al. Subclinical hyperthyroidism as a risk factor for atrial f ibrillation. Am Heart J 2001;142:838–42.
  • 15. Kaminski G, Makowski K, Michałkiewicz D, Kowal J, Ruchala M, Szczepanek E et al. The influence of subclinical hyperthyroidism on blood pressure, heart rate variability, and prevalence of arrhythmias. Thyroid 2012;22:454–60.
  • 16. Straus SM, Kors JA, De Bruin ML, van der Hooft CS, Hofman A, Heeringa J, Deckers JW et al. Prolonged QTc interval and risk of sudden cardiac death in a population of older adults. J Am Coll Cardiol 2006;47:362–7.
  • 17. Borys Surawicz, T.K. Chou’s Electrocardiography in Clinical Practice. 6th ed. PA, Philadelphia: Saunders; 2008. 752 p.
  • 18. FRIDERICIA, L.S. Die Systolendauer im Elektrokardiogramm bei normalen Menschen und bei Herzkranken 1920;5:469–86.
  • 19. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2015;28:1–39.
  • 20. Nagueh SF, Smiseth OA, Appleton CP, Byrd BF 3rd, Dokainish H, Edvardsen T et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2016;29:277–314.
  • 21. Schiller NB, Acquatella H, Ports TA, Drew D, Goerke J, Ringertz H et al. Left ventricular volume from paired biplane twodimensional echocardiography. Circulation 1979;60:547–55.
  • 22. Voigt JU, Pedrizzetti G, Lysyansky P, Marwick TH, Houle H, Baumann R et al. Definitions for a common standard for 2D speckle tracking echocardiography: consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur Heart J Cardiovasc Imaging 2015;16:1–11.
  • 23. Badano LP, Kolias TJ, Muraru D, Abraham TP, Aurigemma G, Edvardsen T et al. Standardization of left atrial, right ventricular, and right atrial deformation imaging using two-dimensional speckle tracking echocardiography: a consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur Heart J Cardiovasc Imaging 2018;19:591–600.
  • 24. Irdem A, Aydın Sahin D, Kervancioglu M, Baspinar O, Sucu M, Keskin M et al. Evaluation of P-Wave Dispersion, Diastolic Function, and Atrial Electromechanical Conduction in Pediatric Patients with Subclinical Hypothyroidism. Echocardiography 2016;33:1397–401.
  • 25. Tayal B, Graff C, Selmer C, Kragholm KH, Kihlstrom M, Nielsen JB et al. Thyroid dysfunction and electrocardiographic changes in subjects without arrhythmias: a cross-sectional study of primary healthcare subjects from Copenhagen. BMJ Open 2019;9:e023854.
  • 26. Rajão KMAB, Ribeiro ALP, Passos VMA, Benseñor IJM, Vidigal PG, Camacho CP et al. Subclinical Thyroid Dysfunction was not Associated with Cardiac Arrhythmias in a Cross-Sectional Analysis of the ELSA-Brasil Study. Arq Bras Cardiol 2019;112:758–66.
  • 27. Marques-Alves P, Espírito-Santo N, Baptista R, Teixeira R, Martins R, Gonçalves F et al. Two-dimensional speckle-tracking global longitudinal strain in high-sensitivity troponin-negative low-risk patients with unstable angina: a “resting ischemia test”? Int J Cardiovasc Imaging 2018;34:561–8.
  • 28. Baruch G, Rothschild E, Sadon S, Szekely Y, Lichter Y, Kaplan A et al. Evolution of right and left ventricle routine and speckle-tracking echocardiography in patients recovering from coronavirus disease 2019: a longitudinal study. Eur Heart J Cardiovasc Imaging 2021;23:1055–65.
  • 29. Tadic M, Ilic S, Kostic N, Caparevic Z, Celic V. Subclinical hypothyroidism and left ventricular mechanics: a threedimensional speckle tracking study. J Clin Endocrinol Metab 2014;99:307–14.
  • 30. Nakanishi K, Daimon M, Yoshida Y, Sawada N, Hirose K, Iwama K et al. Subclinical Hypothyroidism as an Independent Determinant of Left Atrial Dysfunction in the General Population. J Clin Endocrinol Metab 2021;106:e1859–67.

Does Subclinical Hypothyroidism Alter the Axis of QRS and P Waves?

Year 2022, Volume: 12 Issue: 3, 247 - 251, 15.12.2022

Abstract

Aim: What changes subclinical hypothyroidism (SCH) causes on the 12-lead surface electrocardiogram (ECG) has remained elusive. We examined the relationship between subclinical hypothyroidism and cardiac electromechanics, including P wave and QRS axes on ECG and cardiac functions by 2D speckle-tracking echocardiography (2D-STE). Material and Method: This cross-sectional study included 109 SCH patients who presented to the internal disease outpatient clinic between November 10, 2018, and January 30, 2019. ECG, 2D-STE images, and laboratory findings at admission were recorded for all patients. Findings were compared with a sex and age-matched control group of 74 healthy adults.
Results: The median age of the patients was 41 (IQR, 34–50) years, and 76.1% were female. QTc interval was significantly longer in the patient group than in the control group.[435 ms (IQR, 421–457) vs. 424 ms (IQR, 412–438), p=0.001]. The remaining ECG features, including P wave and QRS axes, were similar between the patient and control groups. There were no significant differences between the patients and control group regarding laboratory and echocardiography findings, including left ventricle global longitudinal strain.
Conclusion: According to our findings, individuals with SCH exhibited no change in myocardial mobility as measured by strain echocardiography. In addition, SCH may not cause significant ECG changes, except that these patients have a longer QTc interval than subjects with euthyroidism.

References

  • 1. Klein I, Danzi S. Thyroid Disease and the Heart. Curr Probl Cardiol 2016;41:65–92.
  • 2. I, K. Endocrine disorders and cardiovascular disease. In: Zipes DP, L.P., Bonow RO, Braunwald E, editors. Braunwald’s heart disease: A textbook of cardiovascular medicine. Philadelphia; 2005:2056–63.
  • 3. Selmer C, Olesen JB, Hansen ML, von Kappelgaard LM, Madsen JC, Hansen PR et al. Subclinical and overt thyroid dysfunction and risk of all-cause mortality and cardiovascular events: a large population study. J Clin Endocrinol Metab 2014;99:2372–82.
  • 4. Vanderpump MP, Tunbridge WM, French JM, Appleton D, Bates D, Clark F, Grimley Evans J et al. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey. Clin Endocrinol (Oxf) 1995;43:55–68.
  • 5. Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch Intern Med 2000;160:526–34.
  • 6. Donangelo, I. & Braunstein, G.D. Update on subclinical hyperthyroidism. Am Fam Physician 2011;83:933–8.
  • 7. Alexander B, Tse G, Martinez-Selles M, Baranchuk. Atrial Conduction Disorders. Curr Cardiol Rev 2021;17:68–73.
  • 8. Miceli F, Presta V, Citoni B, Canichella F, Figliuzzi I, Ferrucci A et al. Conventional and new electrocardiographic criteria for hypertension-mediated cardiac organ damage: A narrative review. J Clin Hypertens (Greenwich) 2019;21:1863–71.
  • 9. Ajibare AO, Olabode OP, Fagbemiro EY, Akinlade OM, Akintunde AA, Akinpelu OO et al. Assessment of Ventricular Repolarization in Sickle Cell Anemia Patients: The Role of QTc Interval, Tp-e Interval and Tp-e/QTc Ratio and Its Gender Implication. Vasc Health Risk Manag 2020;16:525–33.
  • 10. Shafi S, Saleem M, Anjum R, Abdullah W, Shafi T. ECG Abnormalities In Patients With Chronic Kidney Disease. J Ayub Med Coll Abbottabad. 2017;29(1):61–4.
  • 11. Kopeć G, Tyrka A, Miszalski-Jamka T, Sobień M, Waligóra M, Brózda M et al. Electrocardiogram for the diagnosis of right ventricular hypertrophy and dilation in idiopathic pulmonary arterial hypertension. Circ J. 2012;76(7):1744–9.
  • 12. Alter P, Watz H, Kahnert K, Rabe KF, Biertz F, Fischer R et al. Effects of airway obstruction and hyperinflation on electrocardiographic axes in COPD. Respir Res 2019;20:61.
  • 13. Li Y, Shah AJ, Soliman EZ. Effect of electrocardiographic P-wave axis on mortality. Am J Cardiol. 2014;113(2):372–6.
  • 14. Auer J, Scheibner P, Mische T, Langsteger W, Eber O, Eber B et al. Subclinical hyperthyroidism as a risk factor for atrial f ibrillation. Am Heart J 2001;142:838–42.
  • 15. Kaminski G, Makowski K, Michałkiewicz D, Kowal J, Ruchala M, Szczepanek E et al. The influence of subclinical hyperthyroidism on blood pressure, heart rate variability, and prevalence of arrhythmias. Thyroid 2012;22:454–60.
  • 16. Straus SM, Kors JA, De Bruin ML, van der Hooft CS, Hofman A, Heeringa J, Deckers JW et al. Prolonged QTc interval and risk of sudden cardiac death in a population of older adults. J Am Coll Cardiol 2006;47:362–7.
  • 17. Borys Surawicz, T.K. Chou’s Electrocardiography in Clinical Practice. 6th ed. PA, Philadelphia: Saunders; 2008. 752 p.
  • 18. FRIDERICIA, L.S. Die Systolendauer im Elektrokardiogramm bei normalen Menschen und bei Herzkranken 1920;5:469–86.
  • 19. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2015;28:1–39.
  • 20. Nagueh SF, Smiseth OA, Appleton CP, Byrd BF 3rd, Dokainish H, Edvardsen T et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2016;29:277–314.
  • 21. Schiller NB, Acquatella H, Ports TA, Drew D, Goerke J, Ringertz H et al. Left ventricular volume from paired biplane twodimensional echocardiography. Circulation 1979;60:547–55.
  • 22. Voigt JU, Pedrizzetti G, Lysyansky P, Marwick TH, Houle H, Baumann R et al. Definitions for a common standard for 2D speckle tracking echocardiography: consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur Heart J Cardiovasc Imaging 2015;16:1–11.
  • 23. Badano LP, Kolias TJ, Muraru D, Abraham TP, Aurigemma G, Edvardsen T et al. Standardization of left atrial, right ventricular, and right atrial deformation imaging using two-dimensional speckle tracking echocardiography: a consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur Heart J Cardiovasc Imaging 2018;19:591–600.
  • 24. Irdem A, Aydın Sahin D, Kervancioglu M, Baspinar O, Sucu M, Keskin M et al. Evaluation of P-Wave Dispersion, Diastolic Function, and Atrial Electromechanical Conduction in Pediatric Patients with Subclinical Hypothyroidism. Echocardiography 2016;33:1397–401.
  • 25. Tayal B, Graff C, Selmer C, Kragholm KH, Kihlstrom M, Nielsen JB et al. Thyroid dysfunction and electrocardiographic changes in subjects without arrhythmias: a cross-sectional study of primary healthcare subjects from Copenhagen. BMJ Open 2019;9:e023854.
  • 26. Rajão KMAB, Ribeiro ALP, Passos VMA, Benseñor IJM, Vidigal PG, Camacho CP et al. Subclinical Thyroid Dysfunction was not Associated with Cardiac Arrhythmias in a Cross-Sectional Analysis of the ELSA-Brasil Study. Arq Bras Cardiol 2019;112:758–66.
  • 27. Marques-Alves P, Espírito-Santo N, Baptista R, Teixeira R, Martins R, Gonçalves F et al. Two-dimensional speckle-tracking global longitudinal strain in high-sensitivity troponin-negative low-risk patients with unstable angina: a “resting ischemia test”? Int J Cardiovasc Imaging 2018;34:561–8.
  • 28. Baruch G, Rothschild E, Sadon S, Szekely Y, Lichter Y, Kaplan A et al. Evolution of right and left ventricle routine and speckle-tracking echocardiography in patients recovering from coronavirus disease 2019: a longitudinal study. Eur Heart J Cardiovasc Imaging 2021;23:1055–65.
  • 29. Tadic M, Ilic S, Kostic N, Caparevic Z, Celic V. Subclinical hypothyroidism and left ventricular mechanics: a threedimensional speckle tracking study. J Clin Endocrinol Metab 2014;99:307–14.
  • 30. Nakanishi K, Daimon M, Yoshida Y, Sawada N, Hirose K, Iwama K et al. Subclinical Hypothyroidism as an Independent Determinant of Left Atrial Dysfunction in the General Population. J Clin Endocrinol Metab 2021;106:e1859–67.
There are 30 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Timor Omar This is me

Metin Çağdaş This is me

Mahmut Yesin This is me

Doğan Ilis This is me

Muammer Karakayalı This is me

İnanc Artac This is me

Mustafa Avcı This is me

Hikmet Utku Odman This is me

Yavuz Karabağ This is me

Ibrahim Rencüzoğulları This is me

Publication Date December 15, 2022
Published in Issue Year 2022 Volume: 12 Issue: 3

Cite

APA Omar, T., Çağdaş, M., Yesin, M., Ilis, D., et al. (2022). Does Subclinical Hypothyroidism Alter the Axis of QRS and P Waves?. Kafkas Journal of Medical Sciences, 12(3), 247-251.
AMA Omar T, Çağdaş M, Yesin M, Ilis D, Karakayalı M, Artac İ, Avcı M, Odman HU, Karabağ Y, Rencüzoğulları I. Does Subclinical Hypothyroidism Alter the Axis of QRS and P Waves?. KAFKAS TIP BİL DERG. December 2022;12(3):247-251.
Chicago Omar, Timor, Metin Çağdaş, Mahmut Yesin, Doğan Ilis, Muammer Karakayalı, İnanc Artac, Mustafa Avcı, Hikmet Utku Odman, Yavuz Karabağ, and Ibrahim Rencüzoğulları. “Does Subclinical Hypothyroidism Alter the Axis of QRS and P Waves?”. Kafkas Journal of Medical Sciences 12, no. 3 (December 2022): 247-51.
EndNote Omar T, Çağdaş M, Yesin M, Ilis D, Karakayalı M, Artac İ, Avcı M, Odman HU, Karabağ Y, Rencüzoğulları I (December 1, 2022) Does Subclinical Hypothyroidism Alter the Axis of QRS and P Waves?. Kafkas Journal of Medical Sciences 12 3 247–251.
IEEE T. Omar, “Does Subclinical Hypothyroidism Alter the Axis of QRS and P Waves?”, KAFKAS TIP BİL DERG, vol. 12, no. 3, pp. 247–251, 2022.
ISNAD Omar, Timor et al. “Does Subclinical Hypothyroidism Alter the Axis of QRS and P Waves?”. Kafkas Journal of Medical Sciences 12/3 (December 2022), 247-251.
JAMA Omar T, Çağdaş M, Yesin M, Ilis D, Karakayalı M, Artac İ, Avcı M, Odman HU, Karabağ Y, Rencüzoğulları I. Does Subclinical Hypothyroidism Alter the Axis of QRS and P Waves?. KAFKAS TIP BİL DERG. 2022;12:247–251.
MLA Omar, Timor et al. “Does Subclinical Hypothyroidism Alter the Axis of QRS and P Waves?”. Kafkas Journal of Medical Sciences, vol. 12, no. 3, 2022, pp. 247-51.
Vancouver Omar T, Çağdaş M, Yesin M, Ilis D, Karakayalı M, Artac İ, Avcı M, Odman HU, Karabağ Y, Rencüzoğulları I. Does Subclinical Hypothyroidism Alter the Axis of QRS and P Waves?. KAFKAS TIP BİL DERG. 2022;12(3):247-51.