A prospective study of two-dimensional echocardiographic assessment of pulmonary artery hypertension in thyroid dysfunction
Harpreet Singh, Gian Chand, Neha Paul, Sapna
Introduction: The association between hyperthyroidism and pulmonary hypertension has been described previously. Though some studies evaluated the prevalence of pulmonary hypertension in patients with hypothyroidism and hyperthyroidism and treatment modalities for reduction of PAH, very few studies have evaluated the effects of treatment of thyroid disease in treatment of PAH. Aim: To study the occurrence of pulmonary hypertension in patients with hypothyroidism and hyperthyroidism and the reversibility of pulmonary hypertension on treating the underlying hypothyroidism and hyperthyroidism thereby reducing the mortality and morbidity associated with pulmonary hypertension. Material and Methods: Total of 75 patients attending outdoor department or admitted in various wards of Guru Nanak Dev Hospital, Amritsar were taken. The patients were divided into 2 groups namely: Group I including 50 Patients of hypothyroidism and hyperthyroidism and Group II with 25 Patients as control. Every subject was subjected to transthoracic two-dimensional echocardiography and pulmonary artery systolic pressure was obtained. All the patients were treated for underlying thyroid dysfunction and those having higher PASP were subjected to repeat two-dimensional echocardiography after a period of 12 weeksof treatment and repeat pulmonary artery systolic pressures were obtained. Results: Hypothyroidism is more common form of thyroid disorder with female predominance. Pulmonary artery hypertension was detected in 24% patients with thyroid dysfunction. None of the patient from the control group had elevated PASP. Pulmonary artery hypertension was more common in hyperthyroid patients. Mean average of PASP in group 1 was 26.89±7.29 whereas in group 2 it was 23.60±1.70. In hyperthyroid patients mean PASP was 31.10±9.80 whereas in hypothyroid patients it was 25.09±5.09. Mean PASP in the pre-treatment group was 36.71±5.96 mmHg whereas in post- treatment group it decreased to 30.27±4.77mmHg. Conclusion: Pulmonary artery hypertension can be reversed after correction of underlying thyroid disorder. Results of our study showed importance of early echocardiography in patients with thyroid dysfunctions for early diagnosis of pulmonary artery hypertension and to timely prevent it.