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Frontal QRS-T açısı ile subklinik hipotiroidizim arasında herhangi bir ilişki var mı?

Yıl 2021, Cilt: 46 Sayı: 3, 1117 - 1124, 30.09.2021
https://doi.org/10.17826/cumj.912292

Öz

Amaç: Bu çalışmada amacımız frontal QRS-T açısı ile subklinik hipotiroidizim (SKH) arasında bir ilişki olup olmadığını değerlendirmektir.
Gereç ve Yöntemler: Çalışmaya, 41 hasta SKH ve 74 sağlıklı kontrol grubu olmak üzere toplam 115 kişi dahil edildi. SKH tanısı için, serum tiroid uyarıcı hormon (TSH) düzeyi> 4,5 mU / mL olarak belirlendi. Tüm hastaların demografik, elektrokardiyografik ve ekokardiyografik verileri iki grup arasında karşılaştırıldı.
Bulgular: TSH seviyesi (5.7 [4.5-20]’e karşın 1.2 [0.4-4.3] mlU / L), vücut kitle indeksi (BMI) (30.7 ± 6.4'e karşın 28.1 ± 5.3 kg/m2) ve frontal QRS-T açı değerleri (40 [2-188]’e karşın 15 [1-86] derece) ) SKH'li hastalarda daha yüksekti. Bununla birlikte, sol ventrikül ejeksiyon fraksiyonu (SVEF) değerleri, SKH hastalarında daha düşüktü (58.9 ± 3.1'e karşın 60.8 ± 2.9) Korelasyon analizlerinde, VKİ (r = 0.267, p = 0.007) ve frontal QRS-T açısı arasında pozitif korelasyon (r = 0,294, p = 0,001), ancak SVEF ile TSH düzeyi arasında negatif korelasyon (r = -0,218, p = 0,019) saptandı. Çok değişkenli doğrusal regresyon analizlerinde, sadece yaş (OO:0.304 95% GA [0.242 – 1.147) and) ve subklinik hipotroidizim (OO:0.407 95% GA [15.175 – 42.494) frontal QRS-T açısı artışı için olası bağımsız birer risk faktörü olarak bulundular.
Sonuç: Frontal QRS-T açısının artması, SKH hastalarda bağımsız bir risk faktörü olduğu bulundu.Frontal QRS-T açısı, SKH'li hastalarda, kardiyovasküler risk tahmininde, önemsenmesi gereken EKG parametrelerinden biri olarak düşünülebilir.

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.
  • 11. Mitchell C, Rahko S, Blauwet LA, et al.Guidelines for Performing a Comprehensive Transthoracic Echocardiographic Examination in adults: Recommendation from the American Society of Echocardiography. J Am Soc Echocardiogr. 2019;32:1-64.
  • 12. Kahaly GJ, Dillmann WH. Thyroid hormone action in the heart. Endocr Rev. 2005;26(5):704-728.
  • 13. Klein I, Danzi S. Thyroid disease and the heart. Circulation. 2007;116(15):1725-1735.
  • 14. Tribulova N, Knezl V, Shainberg A, Seki S, Soukup T. Thyroid hormones and cardiac arrhythmias. Vascul Pharmacol. 2010;52(3-4):102-112.
  • 15. Sara JD, Zhang M, Gharib H, et al. Hypothyroidism Is Associated With Coronary Endothelial Dysfunction in Women, J Am Heart Assoc. 2015;4(8):e002225.
  • 16. 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.
  • 17. Ziegler R, Bloomfield DK. A study of the normal QRS-T angle in the frontal plane. J Electrocardiol 1970;3:161–167.
  • 18. Whang W, Shimbo D, Levitan EB, et al. Relations between QRS/T angle, cardiac risk factors, and mortality in the Third National Health and Nutrition Examination Survey (NHANES III). Am J Cardiol. 2012;109:981-987.

Is there any relationship between frontal QRS-T angle and subclinical hypothyroidism?

Yıl 2021, Cilt: 46 Sayı: 3, 1117 - 1124, 30.09.2021
https://doi.org/10.17826/cumj.912292

Öz

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.

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.
  • 11. Mitchell C, Rahko S, Blauwet LA, et al.Guidelines for Performing a Comprehensive Transthoracic Echocardiographic Examination in adults: Recommendation from the American Society of Echocardiography. J Am Soc Echocardiogr. 2019;32:1-64.
  • 12. Kahaly GJ, Dillmann WH. Thyroid hormone action in the heart. Endocr Rev. 2005;26(5):704-728.
  • 13. Klein I, Danzi S. Thyroid disease and the heart. Circulation. 2007;116(15):1725-1735.
  • 14. Tribulova N, Knezl V, Shainberg A, Seki S, Soukup T. Thyroid hormones and cardiac arrhythmias. Vascul Pharmacol. 2010;52(3-4):102-112.
  • 15. Sara JD, Zhang M, Gharib H, et al. Hypothyroidism Is Associated With Coronary Endothelial Dysfunction in Women, J Am Heart Assoc. 2015;4(8):e002225.
  • 16. 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.
  • 17. Ziegler R, Bloomfield DK. A study of the normal QRS-T angle in the frontal plane. J Electrocardiol 1970;3:161–167.
  • 18. Whang W, Shimbo D, Levitan EB, et al. Relations between QRS/T angle, cardiac risk factors, and mortality in the Third National Health and Nutrition Examination Survey (NHANES III). Am J Cardiol. 2012;109:981-987.
Toplam 18 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Araştırma
Yazarlar

Songul Usalp 0000-0001-9572-5431

Emine Altuntaş 0000-0001-5887-5422

Bayram Bağırtan Bu kişi benim 0000-0001-8136-3820

Ali Bayraktar Bu kişi benim 0000-0001-5219-4087

Yayımlanma Tarihi 30 Eylül 2021
Kabul Tarihi 25 Mayıs 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 46 Sayı: 3

Kaynak Göster

MLA Usalp, Songul vd. “Is There Any Relationship Between Frontal QRS-T Angle and Subclinical Hypothyroidism?”. Cukurova Medical Journal, c. 46, sy. 3, 2021, ss. 1117-24, doi:10.17826/cumj.912292.