A Prospective Study on the Prevalence of Pulmonary Artery Hypertension in Thyroid DysfunctionCorrespondence Address :
Dr. Jahnvi Dhar,
Flat 201, Sabzaar Apartments, Sector 45, GH-4, Faridabad, Haryana-121010, India.
Introduction: Though rare, thyroid dysfunction is known to cause Pulmonary Artery Hypertension (PAH) which is also known to be reversible by restoration of euthyroid state. Hence, timely diagnosis and institution of medications can prevent as well as treat the secondary PAH in these patients.
Aim: To analyse the prevalence of PAH in newly diagnosed, treatment naÔve patients with thyroid dysfunction (hypoth-yroidism/hyperthyroidism) and to analyse the association of thyroid dysfunction with occurrence of PAH in treatment naÔve patients. Furthermore, to see the improvement of PAH in those diagnosed, with treatment given, after 6 months.
Materials and Methods: It was an observational prospective study which included 67 newly diagnosed patients with thyroid dysfunction. All were subjected to 2D echocardiography with detailed history and physical examination. Repeat echocardiographic assessment was done after 6 months of treatment for few patients to look for resolution of PAH. The statistical analysis was carried out to determine the association of PAH with thyroid dysfunction using studentís t-test and chi-square test of association.
Results: The study included 56 (84%) females and 11 (16%) males. PAH was present in 19 (28.3%) patients, with a mean age of presentation of 34.3Ī10.70 years. In the echocardiographic assessment of patients with PAH, tricuspid regurgitation (100%), pericardial effusion (26%), dilatation of right heart chambers (21%), reduced LVEF (16%) and pulmonary regurgitation (5%) were the main findings recorded. Repeat echocardiography after 6 months of treatment (Eltroxin 1.6 microgram/kg for hypothyroid patients and Carbimazole (5/10 mg BD/TDS) for hyperthyroid) was performed in 7 of the 19 patients only (those who were diagnosed with PAH at the time of diagnosis of thyroid dysfunction) and reduction in Pulmonary Artery Systolic Pressure (PASP) was observed in 3 of them.
Conclusion: High prevalence (28.3%) of PAH was observed in patients with thyroid dysfunctions at the time of diagnosis in the treatment naÔve patients in the current study and it also reversed with treatment in three out of 7 patients on repeat 2D-echo with treatment. It is, therefore, suggested that every patient of thyroid dysfunction should be screened for PAH, even though further studies are needed to substantiate this, due to an inherent small sample size of the study.
Hypothyroidism, Hyperthyroidism, Pulmonary artery hypertension, 2D-echocardiography
Sunita Aggarwal, Vivek Chaturvedi, Sandeep Garg, Mradul Kumar Daga, Shraddha Sharma, Jahnvi Dhar. A PROSPECTIVE STUDY ON THE PREVALENCE OF PULMONARY ARTERY HYPERTENSION IN THYROID DYSFUNCTION. Journal of Clinical and Diagnostic Research [serial online] 2018 August [cited: 2018 Aug 14 ]; 12:OC30-OC33. Available from
Date of Submission: Sep 19, 2017
Date of Peer Review: Nov 28, 2017
Date of Acceptance: May 25, 2018
Date of Publishing: Aug 01, 2018
FINANCIAL OR OTHER COMPETING INTERESTS: None.
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