title: Echocardiographic assessment of left ventricular function in thyrotoxicosis and implications for the therapeutics of thyrotoxic cardiac disease.
abstract: BACKGROUND
  Thyrotoxicosis is an endocrine disorder with prominent cardiovascular manifestations. Thyroid hormone acts through genomic and non-genomic mechanisms to regulate cardiac function. Echocardiography is a useful, non-invasive, easily accessible, and affordable tool for studying the structural and physiological function of the heart.
  
  
  OBJECTIVE
  We studied thyrotoxicosis patients in a Nigerian Teaching Hospital and employed trans-thoracic echocardiography to find out if there were abnormalities in the hearts of these patients.
  
  
  METHODS
  Fifty adult thyrotoxicosis patients diagnosed with clinical and thyroid function tests in the medical out-patient unit of the hospital were recruited and we performed transthoracic echocardiography with a Sonos 2000 HP machine.
  
  
  RESULTS
  We documented the presence of abnormalities in the following proportion of thyrotoxicosis patients: left ventricular enhanced systolic function in 30%, enhanced diastolic function in 34%, diastolic dysfunction in 34%, heart failure with preserved ejection fraction in10%, heart failure with reduced ejection fraction in 6%, and left ventricular hypertrophy in 34%.
  
  
  CONCLUSIONS
  Echocardiography was useful in the stratification of cardiac function abnormalities and is indispensable as a guide in the choice of therapeutic options in patients with thyrocardiac disease. The finding of left ventricular enhanced systolic and diastolic functions signify early echocardiographic detectable cardiac abnormalities in thyrotoxicosis, and the clinical management includes the use of anti-thyroid drugs and β-adrenoceptor blockade. Diastolic dysfunction in thyrotoxicosis patients asymptomatic for cardiac disease should be treated with anti-thyroid drugs, and β-adrenoceptor blockade. The judicious application of clinical therapeutics will guide the use of anti-thyroid drugs, diuretics, digoxin, angiotensin inhibitors, and β-adrenoceptor blockade in the successful management of thyrotoxicosis patients with heart failure and reduced, preserved, or increased ejection fraction: parameters which are derived from echocardiography.
authors.affiliation: Department of Pharmacology and Therapeutics, University of Nigeria, Nsukka, Enugu State, Nigeria ; Department of Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria.
authors.forename: Raphael C
authors.initials: RC
authors.lastname: Anakwue
authors.affiliation: Department of Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria.
authors.forename: Basden J
authors.initials: BJ
authors.lastname: Onwubere
authors.affiliation: Department of Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria.
authors.forename: Vincent
authors.initials: V
authors.lastname: Ikeh
authors.affiliation: Department of Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria.
authors.forename: Benedict
authors.initials: B
authors.lastname: Anisiuba
authors.affiliation: Department of Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria.
authors.forename: Samuel
authors.initials: S
authors.lastname: Ike
authors.affiliation: Department of Radiography and Radiological Sciences, Imaging Unit, College of Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria.
authors.forename: Angel-Mary C
authors.initials: AM
authors.lastname: Anakwue
keywords: echocardiography; left ventricle; therapeutics; thyrocardiac disease; thyrotoxicosis