title: [In patients with Graves' disease signal-averaged P wave duration positively correlates with the degree of thyrotoxicosis].
abstract: Coexistence of the goitre, proptosis and palpitations was observed in XIX century for the first time. Sinus tachyarytmias and atrial fibrillation are typical cardiac symptoms of hyperthyroidism. Atrial fibrillation occurs more often in patients with toxic goiter than in young patients with Grave's disease. These findings suggest that causes of atrial fibrillation might be multifactorial in the elderly. The aims of our study were to evaluate correlations between the parameters of atrial signal averaged ECG (SAECG) and the serum concentration of thyroid free hormones. 25 patient with untreated Grave's disease (G-B) (age 29,6 +/- 9,0 y.o.) and 26 control patients (age 29,3 +/- 6,9 y.o.) were enrolled to our study. None of them had history of atrial fibrillation what was confirmed by 24-hour ECG Holter monitoring. The serum fT3, fT4, TSH were determined in the venous blood by the immunoenzymatic method. Atrial SAECG recording with filtration by zero phase Butterworth filter (45-150 Hz) was done in all subjects. The duration of atrial vector magnitude (hfP) and root meat square of terminal 20ms of atrial vector magnitude (RMS20) were analysed. There were no significant differences in values of SAECG parameters (hfP, RMS20) between investigated groups. The positive correlation between hfP and serum fT3 concentration in group G-B was observed (Spearman's correlation coefficient R = 0.462, p < 0.02). No significant correlations were found between RMS20 and serum fT3 in G-B group and between hfP or RMS 20 and serum fT3 in group K. These findings suggest that occurrence of atrial fibrillation in patients with Grave's disease depends not only on hyperthyroidism but on serum concentration of fT3 also.
authors.affiliation: Katedra i Klinika Chorób Wewnetrznych i Endokrynologii Akademii Medycznej w Warszawie. mczark@amwaw.edu.pl
authors.forename: Marek
authors.initials: M
authors.lastname: Czarkowski
authors.forename: Artur
authors.initials: A
authors.lastname: Oreziak
authors.forename: Dariusz
authors.initials: D
authors.lastname: Radomski
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000209:etiology*; D003936:Diagnosis, Computer-Assisted; D015716:Electrocardiography, Ambulatory; D005260:Female; D006111:Graves Disease / Q000145:classification* / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008297:Male; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted