PDF(Pubmed)
Abstract：
BACKGROUND: The deterioration of thyroid health is involved in the progression of heart failure (HF). This is usually a lengthy process, so there are almost no reports on its rapid development. Here we report a case of a young male who rapidly developed hypothyroid cardiomyopathy secondary to radioactive iodine treatment, suggesting that severe HF might occur even after a short period of hypothyroidism.
METHODS: A 26-year-old man was referred to our hospital for HF presenting with dyspnea on exertion and chest discomfort lasting for 1 mo. He received radioactive iodine treatment for hyperthyroidism 1 year ago and had an almost normal echocardiogram 6 mo ago. Admission echocardiogram and cardiac magnetic resonance (CMR) revealed left ventricle (LV) global hypokinesia and severely depressed systolic function. In addition, late gadolinium enhancement indicated no obvious changes in the myocardium. Thyroid function tests showed decreased serum levels of thyroid hormone (TH) and elevated thyroid-stimulating hormone. Based on an exclusionary examination, the patient was diagnosed with hypothyroid cardiomyopathy and was started on replacement therapy. His HF symptoms were completely relieved during the six-month follow-up, and echocardiogram and CMR revealed recovered LV size and ejection fraction.
CONCLUSIONS: This report demonstrates that severe fluctuations in TH levels may lead to acute HF, which can completely recover with timely thyroid hormone replacement. In addition, our findings highlight the importance of routinely detecting cardiac function in patients treated with radioactive iodine.
METHODS: A 26-year-old man was referred to our hospital for HF presenting with dyspnea on exertion and chest discomfort lasting for 1 mo. He received radioactive iodine treatment for hyperthyroidism 1 year ago and had an almost normal echocardiogram 6 mo ago. Admission echocardiogram and cardiac magnetic resonance (CMR) revealed left ventricle (LV) global hypokinesia and severely depressed systolic function. In addition, late gadolinium enhancement indicated no obvious changes in the myocardium. Thyroid function tests showed decreased serum levels of thyroid hormone (TH) and elevated thyroid-stimulating hormone. Based on an exclusionary examination, the patient was diagnosed with hypothyroid cardiomyopathy and was started on replacement therapy. His HF symptoms were completely relieved during the six-month follow-up, and echocardiogram and CMR revealed recovered LV size and ejection fraction.
CONCLUSIONS: This report demonstrates that severe fluctuations in TH levels may lead to acute HF, which can completely recover with timely thyroid hormone replacement. In addition, our findings highlight the importance of routinely detecting cardiac function in patients treated with radioactive iodine.
摘要：
背景：甲状腺健康的恶化与心力衰竭（HF）的进展有关。这通常是一个漫长的过程，因此几乎没有关于其快速发展的报道。在这里，我们报告了一例年轻男性，他迅速发展为继发于放射性碘治疗的甲状腺功能减退性心肌病，提示即使在短时间的甲状腺功能减退症后也可能发生严重的HF。
方法：一名26岁的男子因心力衰竭被转诊到我们医院，表现为劳累性呼吸困难和持续1个月的胸部不适。1年前，他接受了甲状腺功能亢进的放射性碘治疗，6个月前的超声心动图几乎正常。入院超声心动图和心脏磁共振（CMR）显示左心室（LV）整体运动功能减退和收缩功能严重下降。此外,钆的晚期增强表明心肌没有明显变化。甲状腺功能检查显示血清甲状腺激素（TH）水平降低，促甲状腺激素升高。根据排除性检查，患者被诊断为甲状腺功能减退性心肌病,并开始接受替代治疗.他的HF症状在六个月的随访中完全缓解，超声心动图和CMR显示左心室大小和射血分数恢复。
结论：本报告表明，TH水平的严重波动可能导致急性HF，及时补充甲状腺激素可以完全恢复。此外,我们的研究结果强调了在接受放射性碘治疗的患者中常规检测心功能的重要性.
方法：一名26岁的男子因心力衰竭被转诊到我们医院，表现为劳累性呼吸困难和持续1个月的胸部不适。1年前，他接受了甲状腺功能亢进的放射性碘治疗，6个月前的超声心动图几乎正常。入院超声心动图和心脏磁共振（CMR）显示左心室（LV）整体运动功能减退和收缩功能严重下降。此外,钆的晚期增强表明心肌没有明显变化。甲状腺功能检查显示血清甲状腺激素（TH）水平降低，促甲状腺激素升高。根据排除性检查，患者被诊断为甲状腺功能减退性心肌病,并开始接受替代治疗.他的HF症状在六个月的随访中完全缓解，超声心动图和CMR显示左心室大小和射血分数恢复。
结论：本报告表明，TH水平的严重波动可能导致急性HF，及时补充甲状腺激素可以完全恢复。此外,我们的研究结果强调了在接受放射性碘治疗的患者中常规检测心功能的重要性.
