title: Hyperthyroidism affects arterial stiffness, plasma NT-pro-B-type natriuretic peptide levels, and subendocardial perfusion in patients with Graves' disease.
abstract: BACKGROUND
  Arterial stiffness is thought to play a critical role in the pathogenesis of cardiovascular events, and in hyperthyroidism increased cardiovascular event rates have been reported.
  
  
  OBJECTIVE
  To investigate markers of systemic arterial stiffness, volume homeostasis, and subendocardial perfusion and its interrelationship in patients with Graves' disease (GD) in hyperthyroidism and euthyroidism.
  
  
  METHODS
  Aortic augmentation index (AIx@75) as a measure of systemic arterial stiffness and subendocardial viability ratio (SEVR) as a surrogate measure of subendocardial perfusion were assessed by applanation tonometry in 59 patients with GD in hyperthyroidism and euthyroidism, and measurements were compared to plasma levels of NT-pro-B-type natriuretic peptide (NT-ProBNP).
  
  
  RESULTS
  AIx@75 and NT-ProBNP levels were significantly increased in hyperthyroidism compared to euthyroidism and were positively correlated with each other. SEVR was significantly decreased in hyperthyroidism compared to euthyroidism, mainly due to increased heart rates as shown by the heart rate-corrected SEVR75.
  
  
  CONCLUSIONS
  In hyperthyroidism, patients with GD exhibited increased systemic arterial stiffness, paralleled by increased levels of NT-ProBNP, a marker of volume overload. The decreased subendocardial perfusion in hyperthyroidism seemed to be mainly due to increased heart rates. The observed unfavorable hemodynamic alterations in hyperthyroidism may serve to explain increased cardiovascular event rates in patients with GD.
authors.affiliation: Second Department of Medicine, General Hospital Linz, Linz, Austria. gerd.bodlaj@akh.linz.at
authors.forename: Gerd
authors.initials: G
authors.lastname: Bodlaj
authors.forename: Robert
authors.initials: R
authors.lastname: Pichler
authors.forename: Walter
authors.initials: W
authors.lastname: Brandstätter
authors.forename: Margit
authors.initials: M
authors.lastname: Hatzl-Griesenhofer
authors.forename: Wilhelmine
authors.initials: W
authors.lastname: Maschek
authors.forename: Georg
authors.initials: G
authors.lastname: Biesenbach
authors.forename: Jörg
authors.initials: J
authors.lastname: Berg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001158:Arteries / Q000473:pathology*; D004548:Elasticity; D005260:Female; D006111:Graves Disease / Q000097:blood; D006801:Humans; D006980:Hyperthyroidism / Q000097:blood / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D014284:Triiodothyronine; D020097:Natriuretic Peptide, Brain; D013974:Thyroxine