Hyperthyroidism affects arterial stiffness, plasma NT-pro-B-type natriuretic peptide levels, and subendocardial perfusion in patients with Graves' disease.
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.
Bodlaj
Gerd
G
Second Department of Medicine, General Hospital Linz, Linz, Austria. gerd.bodlaj@akh.linz.at
Pichler
Robert
R
Brandstätter
Walter
W
Hatzl-Griesenhofer
Margit
M
Maschek
Wilhelmine
W
Biesenbach
Georg
G
Berg
Jörg
J
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
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D014284:Triiodothyronine; D020097:Natriuretic Peptide, Brain; D013974:Thyroxine