title: Treatment of subclinical hyperthyroidism: effect on left ventricular mass and function of the heart using magnetic resonance imaging technique.
abstract: OBJECTIVE
  The aim of this study was to investigate structure and function of the heart in subclinical hyperthyroidism (SH) before and after obtaining euthyroidism by radioactive iodine treatment, using high precision and observer-independent magnetic resonance imaging (MRI) technology.
  
  
  METHODS
  Cardiac MRI was performed before and after euthyroidism was obtained by radioactive iodine treatment in 12 otherwise healthy patients (11 women and one man, mean age 59 years, range 44-71 years) with a nodular goiter and SH, and compared with eight healthy controls investigated at baseline. Cardiac data were expressed as an index, as per body surface area, except for heart rate (HR) and ejection fraction.
  
  
  RESULTS
  Post-treatment cardiac MRI was performed in median 139 days after a normalized serum TSH value had been recorded. During treatment, serum TSH increased from (median (range)) 0.01 (0.01-0.09) to 0.88 (0.27-3.99) mU/l. Patients with untreated SH had increased resting HR (P<0.01) as well as cardiac index (cardiac output as per body surface area) (P<0.01) compared with controls. Obtaining euthyroidism resulted in a significant decrease in left ventricular mass index (LVMI) of 2.7 g/m(2) (P=0.034), in HR of 8 bpm (P=0.001), and in cardiac index of 0.24 l/min per m(2) (P=0.017).
  
  
  CONCLUSIONS
  Normalization of thyroid function by radioactive iodine treatment of SH resulted in significant reductions in clinically important heart parameters such as LVMI, HR, and cardiac index. SH should be regarded as a condition in which aggressive treatment should be considered to protect cardiac function.
authors.affiliation: Department of Medicine OCentre of Endocrinology and Metabolism, Herlev University Hospital, Herlev Ringvej 75, Herlev DK-2730, DenmarkDepartment of Clinical Physiology and Nuclear MedicineFrederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, DenmarkDepartment of Clinical PhysiologyNuclear Medicine and PET, Rigshospitalet, Blegdamsvej 9, København Ø, DenmarkFaculty of Health SciencesUniversity of Copenhagen, Blegdamsvej 3B, 2200 København N, DenmarkCenter for Functional and Diagnostic Imaging and ResearchHvidovre University Hospital, Kettegård Allé 30, 2650 Hvidovre, Denmark peterdallmark@gmail.com.
authors.forename: Peter D
authors.initials: PD
authors.lastname: Mark
authors.affiliation: Department of Medicine OCentre of Endocrinology and Metabolism, Herlev University Hospital, Herlev Ringvej 75, Herlev DK-2730, DenmarkDepartment of Clinical Physiology and Nuclear MedicineFrederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, DenmarkDepartment of Clinical PhysiologyNuclear Medicine and PET, Rigshospitalet, Blegdamsvej 9, København Ø, DenmarkFaculty of Health SciencesUniversity of Copenhagen, Blegdamsvej 3B, 2200 København N, DenmarkCenter for Functional and Diagnostic Imaging and ResearchHvidovre University Hospital, Kettegård Allé 30, 2650 Hvidovre, Denmark.
authors.forename: Mikkel
authors.initials: M
authors.lastname: Andreassen
authors.affiliation: Department of Medicine OCentre of Endocrinology and Metabolism, Herlev University Hospital, Herlev Ringvej 75, Herlev DK-2730, DenmarkDepartment of Clinical Physiology and Nuclear MedicineFrederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, DenmarkDepartment of Clinical PhysiologyNuclear Medicine and PET, Rigshospitalet, Blegdamsvej 9, København Ø, DenmarkFaculty of Health SciencesUniversity of Copenhagen, Blegdamsvej 3B, 2200 København N, DenmarkCenter for Functional and Diagnostic Imaging and ResearchHvidovre University Hospital, Kettegård Allé 30, 2650 Hvidovre, Denmark Department of Medicine OCentre of Endocrinology and Metabolism, Herlev University Hospital, Herlev Ringvej 75, Herlev DK-2730, DenmarkDepartment of Clinical Physiology and Nuclear MedicineFrederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, DenmarkDepartment of Clinical PhysiologyNuclear Medicine and PET, Rigshospitalet, Blegdamsvej 9, København Ø, DenmarkFaculty of Health SciencesUniversity of Copenhagen, Blegdamsvej 3B, 2200 København N, DenmarkCenter for Functional and Diagnostic Imaging and ResearchHvidovre University Hospital, Kettegård Allé 30, 2650 Hvidovre, Denmark.
authors.forename: Claus L
authors.initials: CL
authors.lastname: Petersen
authors.affiliation: Department of Medicine OCentre of Endocrinology and Metabolism, Herlev University Hospital, Herlev Ringvej 75, Herlev DK-2730, DenmarkDepartment of Clinical Physiology and Nuclear MedicineFrederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, DenmarkDepartment of Clinical PhysiologyNuclear Medicine and PET, Rigshospitalet, Blegdamsvej 9, København Ø, DenmarkFaculty of Health SciencesUniversity of Copenhagen, Blegdamsvej 3B, 2200 København N, DenmarkCenter for Functional and Diagnostic Imaging and ResearchHvidovre University Hospital, Kettegård Allé 30, 2650 Hvidovre, Denmark Department of Medicine OCentre of Endocrinology and Metabolism, Herlev University Hospital, Herlev Ringvej 75, Herlev DK-2730, DenmarkDepartment of Clinical Physiology and Nuclear MedicineFrederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, DenmarkDepartment of Clinical PhysiologyNuclear Medicine and PET, Rigshospitalet, Blegdamsvej 9, København Ø, DenmarkFaculty of Health SciencesUniversity of Copenhagen, Blegdamsvej 3B, 2200 København N, DenmarkCenter for Functional and Diagnostic Imaging and ResearchHvidovre University Hospital, Kettegård Allé 30, 2650 Hvidovre, Denmark.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kjaer
authors.affiliation: Department of Medicine OCentre of Endocrinology and Metabolism, Herlev University Hospital, Herlev Ringvej 75, Herlev DK-2730, DenmarkDepartment of Clinical Physiology and Nuclear MedicineFrederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, DenmarkDepartment of Clinical PhysiologyNuclear Medicine and PET, Rigshospitalet, Blegdamsvej 9, København Ø, DenmarkFaculty of Health SciencesUniversity of Copenhagen, Blegdamsvej 3B, 2200 København N, DenmarkCenter for Functional and Diagnostic Imaging and ResearchHvidovre University Hospital, Kettegård Allé 30, 2650 Hvidovre, Denmark Department of Medicine OCentre of Endocrinology and Metabolism, Herlev University Hospital, Herlev Ringvej 75, Herlev DK-2730, DenmarkDepartment of Clinical Physiology and Nuclear MedicineFrederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, DenmarkDepartment of Clinical PhysiologyNuclear Medicine and PET, Rigshospitalet, Blegdamsvej 9, København Ø, DenmarkFaculty of Health SciencesUniversity of Copenhagen, Blegdamsvej 3B, 2200 København N, DenmarkCenter for Functional and Diagnostic Imaging and ResearchHvidovre University Hospital, Kettegård Allé 30, 2650 Hvidovre, Denmark.
authors.forename: Jens
authors.initials: J
authors.lastname: Faber
keywords: MRI; cardiac effects; subclinical hyperthyroidism; treatment