Is there any relationship between frontal QRS-T angle and subclinical hypothyroidism?
Abstract
Purpose: The aim of this study was to evaluate whether there is a relationship between frontal QRS-T angle on ECG and subclinical hypothyroidism (SCH).
Materials and Methods: A total of 115 individuals included in this study, 41 patients have SCH and 74 individuals as healthy control group. Serum thyroid-stimulating hormone (TSH) level > 4.5 mU/mL was determined for the diagnosis of SCH. All patients demographic, electrocardiographic and echocardiographic data were collected and compared between the two groups.
Results: The TSH level (5.7 [4.5-20] vs 1.2 [0.4-4.3] mlU/L), body mass index (BMI) (30.7 ± 6.4 vs 28.1 ± 5.3 kg/m2) and frontal QRS-T angle values (40 [2-188] vs 15 [1-86] degree) were higher in patients with SCH. However, left ventricular ejection fraction (LVEF) values were lower in subclinical hypothyroidism patients (58.9 ± 3.1 vs 60.8 ± 2.9). Correlations analysis showed the BMI (r=0.267, p=0.007) and frontal QRS-T angle were positively correlated (r=0.294, p=0.001), but LVEF were negatively correlated (r=-0.218, p=0.019) with TSH level. The multivariable linear regression analysis revealed that only age (OR:0.304 95% CI [0.242 – 1.147]) and), and subclinical hypothyroidism (OR:0.407 95% CI [15.175 – 42.494]) were a potential risk factors for increased of frontal QRS-T angle.
Conclusion: The SCH was found to be an independent risk factor for increased of frontal QRS-T angle.Frontal QRS-T angle can be considered as one of the ECG parameters that should be noted in cardiovascular risk estimation in patients with SCH.
Keywords
Subclinical hypotyroidism , electrocardiography , frontal QRS-T angle
Kaynakça
- 1. Helfand M. U.S. Preventive Services Task Force.Screening for subclinical thyroid dysfunction in nonpregnant adults: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2004;140:128-41.
- 2. Pearce SHS, Brabant G, Duntas LH, et al. 2013 ETA Guidelines: Management of Subclinical Hypothyroidism. Eur Thyroid J 2013;2:215-228.
- 3. Garber JR, Cobin RH, Gharib H, et al. Clinical Practice Guidelines for Hypothyroidism in Adults: Cosponsored by the American Association of Clinical Endocrinologist and the American Thyroid Association. Endocrine Practice. 2012;18:988-1020.
- 4. Ochs N, Auer R, Bauer DC, et al. Meta-analysis: Subclinical Thyroid Dysfunction and the Risk for Coronary Heart Disease and Mortality. Ann Intern Med. 2008;148(11):832-845.
- 5. Kanaya AM, Harris F, Volpato S, et al. Association between thyroid dysfunction and total cholesterol level in an older biracial population: the health, ageing and body composition study. Arch Intern Med. 2002;162:773-779.
- 6. Rodondi N, den Elzen WP, Bauer DC, et al, Thyroid Studies Collaboration: Subclinical hypothyroidism and the risk of coronary heart disease and mortality. JAMA 2010;304:1365–1374.
- 7. Udovcic M, Pena RH, Patham B, et al. Hypothyroidism and Heart. Methodist Debakey Cardiovasc J. 2017;13(2):55-59.
- 8. Oehler A, Feldman T, Henrikson CA, Tereshcenko LG. QRS-T angle: a review. Ann Noninvasive Electrocardiol. 2014;19:534-542.
- 9. Hollowell JG, Staehling NW, Flanders WD, et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab. 2002;87:489-499.
- 10. Tse G, Yan BP. Traditional and novel electrocardiographic conduction and repolarization markers of sudden cardiac death. Europace. 2017;19 (5):712-721.
