1. bookVolume 57 (2019): Issue 2 (June 2019)
Journal Details
License
Format
Journal
eISSN
2501-062X
First Published
30 Mar 2015
Publication timeframe
4 times per year
Languages
English
Open Access

The relationship between the TSH values and the Tpeak – Tend interval duration in hypothyroid patients receiving Levothyroxine treatment

Published Online: 20 Jun 2019
Volume & Issue: Volume 57 (2019) - Issue 2 (June 2019)
Page range: 175 - 180
Received: 21 Nov 2018
Journal Details
License
Format
Journal
eISSN
2501-062X
First Published
30 Mar 2015
Publication timeframe
4 times per year
Languages
English
Abstract

Introduction. Changes in thyroid hormone level can affect the cardiovascular system. The aim of this study was to show how the Tpeak -Tend (Tpe) interval, which is a new marker of ventricular arrythmia, is affected in patients who have become euthyroid following Levothyroxine treatment for hypothyroidism, as this has not been examined previously in literature.

Materials and Methods. This, cross-sectional study included a total of 119 females aged 18-45 years, separated into 3 groups as hypothyroid, euthyroid and control groups. For evaluation of the QTc and Tpe intervals, examination on precordial V5 lead was made of all the ECGs taken routinely on presentation of the patients.

Results. The Tpe and QTc intervals of the hypothyroid group were determined to be significantly prolonged compared to those of the euthyroid and control groups (p < 0.001) and the values of the euthyroid and control groups were similar. A positive correlation was determined between TSH levels and Tpe and QTc intervals. Tpe interval AUC = 0.801 (%95 CI: 0.719 – 0.884) was higher than that of QTc AUC = 0.689 (%95 CI: 0.591 – 0.786).

Conclusions. The Tpe duration was evaluated in respect of the risk of arrythmia in hypothyroid patients. In patients who had become euthyroid, the Tpe interval was found to be similar to that of healthy individuals and was more predictive than QTc. In the light of these findings it can be recommended that measurement of the Tpe interval should be preferred to QTc as a marker of the arrythmogenic effect in hypothyroid patients.

Keywords

1. SANGSTER, J.K.,. PANCİERA D.L, ABBOTT J.A. Cardiovascular effects of thyroid disease. Compend Contin Educ Vet; 2013. 35(7): p. E5.Search in Google Scholar

2. DİLLMANN, W.H., Biochemical basis of thyroid hormone action in the heart. Am J Med, 1990. 88(6):626-30.10.1016/0002-9343(90)90530-QSearch in Google Scholar

3. ZAİDİ, M., et al. Dispersion of ventricular repolarisation: a marker of ventricular arrhythmias in patients with previous myocardial infarction. Heart, 1997. 78(4): 371-5.10.1136/hrt.78.4.371Search in Google Scholar

4. YAMAGUCHİ, M., et al., T wave peak-to-end interval and QT dispersion in acquired long QT syndrome: a new index for arrhythmogenicity. Clin Sci (Lond), 2003. 105(6):671-6.10.1042/CS20030010Search in Google Scholar

5. YAN, G.X., ANTZELEVİTCH C. Cellular basis for the normal T wave and the electrocardiographic manifestations of the long-QT syndrome. Circulation, 1998. 98(18): 1928-36.10.1161/01.CIR.98.18.1928Search in Google Scholar

6. GALETTA, F. et al., Changes in heart rate variability and QT dispersion in patients with overt hypothyroidism. European Journal of Endocrinology 2008. 158(1):85-90.10.1530/EJE-07-0357Search in Google Scholar

7. ALTUN, A., et al., The relationship between ventricular repolarization and thyroid stimulating hormone. Ann Noninvasive Electrocardiogr, 1998. 3:19.Search in Google Scholar

8. NATHANİEL C, C.L., AZRİN MA. QTc prolongation in hypothyroidism. J Am Coll Cardiol, 1994. 23:36A.Search in Google Scholar

9. SHARP, N.A., NEEL D.S., PARSONS R.L. Influence of thyroid hormone levels on the electrical and mechanical properties of rabbit papillary muscle. J Mol Cell Cardiol, 1985. 17(2): 119-32.10.1016/S0022-2828(85)80015-8Search in Google Scholar

10. FUNCK-BRENTANO, C, JAİLLON P. Rate-corrected QT interval: techniques and limitations. Am J Cardiol, 1993. 72(6):17b-22b.10.1016/0002-9149(93)90035-BSearch in Google Scholar

11. GURDAL, A., et al., Evaluation of Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio in patients with subclinical hypothyroidism. Ther Adv Endocrinol Metab, 2017. 8(3):25-32.10.1177/2042018816684423536345328377800Search in Google Scholar

12. KWEON K.H., PARK B.H., CHO C.G. The Effects of L-thyroxine Treatment on QT Dispersion in Primary Hypothyroidism. Journal of Korean Medical Science, 2007. 22(1): 114-116.10.3346/jkms.2007.22.1.114269354517297262Search in Google Scholar

13. YONTAR, O.C., et al., Assessment of ventricular repolarization inhomogeneity in patients with mitral valve prolapse: value of T wave peak to end interval. International Journal of Clinical and Experimental Medicine, 2014. 7(8):2173-2178.Search in Google Scholar

14. PANİKKATH, R., et al., Prolonged Tpeak to Tend Interval on the Resting Electrocardiogram Is Associated with Increased Risk of Sudden Cardiac Death. Circulation. Arrhythmia and electrophysiology, 2011. 4(4):441-447.10.1161/CIRCEP.110.960658315754721593198Search in Google Scholar

Recommended articles from Trend MD

Plan your remote conference with Sciendo