[The importance of bisoprolol in prevention of heart left ventricular hypertrophy in patients with long term L-thyroxin suppressive therapy, after the operation of differentiated thyroid carcinoma].
BACKGROUND
Patients with differentiated thyroid carcinoma have to undergo radical surgical treatment, which includes total thyreoidectomy, radioiodine therapy and a life-time suppressive therapy with L-thyroxine. The aim of this study was a prospective evaluation of left ventricular hypertrophy during L suppressive-thyroxine treatment in patients treated for differentiated thyroid carcinoma.


METHODS
The examined group comprised 50 patients with differentiated thyroid carcinoma, treated by total thyroidectomy and 131I therapy. Echocardiographic measurements were needed for estimation of left ventricular mass and its index, according to recommendations of American Echocardiography Society.


RESULTS
During two-years long suppressive therapy we observed a significant rise in left ventricular mass. In woman group left ventricular mass was increased from 168+/-39 g to 204+/-45 g (p<0.001) and in men from 205+/-60 to 320+/-21 g. Likewise, left ventricular mass index was increased in women group from 96+/-18 g/m(2) to 116+/-25 g/m(2) (p<0.001) and in men group from 107+/-37 g/m(2) to 158+/-28 g/m(2). Simultaneous treatment with bisoprolol caused a regression of left myocardial hypertrophy. Already after 6 months of simultaneous treatment with L-thyroxin and bisoprolol, for left ventricular mass was reduced to normal: in woman 165+/-35 g, and in men to 178+/-38 g. Analogous results were obtained left ventricular mass index. After 6 months it was reduced to 94+/-12 g/m(2) in woman and in men to 132+/-32 g/m(2).


CONCLUSIONS
1. In differentiated thyroid cancer patients, treated postoperatively with L-thyroxine suppressive therapy, left ventricular hypertrophy is observed already during the first year of suppressive therapy and progresses during the next year of treatment. 2 Addition of a beta-adrenergic antagonist to suppressive doses of L-thyroxine causes a regression of left ventricular hypertrophy, thus, beta-adrenergic antagonists should be administered in this group of patients.
Kliniczny Oddział Chorób Wewnetrznych i Dermatologii, Szpitala Specjalistycznego nr 2, Zabrze. gabelka7@onet.eu
Gabriela
G
Matuszewska
Bogdan
B
Marek
Dariusz
D
Kajdaniuk
Brygida
B
Przywara-Chowaniec
Jerzy
J
Jarzab
Barbara
B
Jarzab
D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D017298:Bisoprolol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000139:chemically induced / Q000188:drug therapy*; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013964:Thyroid Neoplasms / Q000628:therapy; D013974:Thyroxine / Q000009:adverse effects* / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D007457:Iodine Radioisotopes; D013974:Thyroxine; D017298:Bisoprolol