Total Thyroidectomy in Patients with Amiodarone-Induced Thyrotoxicosis and Severe Left Ventricular Systolic Dysfunction (Articolo in rivista)

Type
Label
  • Total Thyroidectomy in Patients with Amiodarone-Induced Thyrotoxicosis and Severe Left Ventricular Systolic Dysfunction (Articolo in rivista) (literal)
Anno
  • 2012-01-01T00:00:00+01:00 (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#doi
  • 10.1210/jc.2012-1797 (literal)
Alternative label
  • Tomisti, Luca; Materazzi, Gabriele; Bartalena, Luigi; Rossi, Giuseppe; Marchello, Angelica; Moretti, Manuela; De Napoli, Luigi; Mariotti, Rita; Miccoli, Paolo; Martino, Enio; Bogazzi, Fausto (2012)
    Total Thyroidectomy in Patients with Amiodarone-Induced Thyrotoxicosis and Severe Left Ventricular Systolic Dysfunction
    in The Journal of clinical endocrinology and metabolism
    (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#autori
  • Tomisti, Luca; Materazzi, Gabriele; Bartalena, Luigi; Rossi, Giuseppe; Marchello, Angelica; Moretti, Manuela; De Napoli, Luigi; Mariotti, Rita; Miccoli, Paolo; Martino, Enio; Bogazzi, Fausto (literal)
Pagina inizio
  • 3515 (literal)
Pagina fine
  • 3521 (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#numeroVolume
  • 97 (literal)
Rivista
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#pagineTotali
  • 7 (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#numeroFascicolo
  • 10 (literal)
Note
  • ISI Web of Science (WOS) (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#affiliazioni
  • Departments of Endocrinology and Metabolism (L.T., A.M., E.M., F.B.) and Surgery (G.M., M.M., L.D.N., P.M.), and Cardio-Thoracic Department (R.M.), University of Pisa, 56124 Pisa, Italy; Department of Clinical and Experimental Medicine (L.B.), University of Insubria, 21100 Varese, Italy; andUnit of Epidemiology and Biostatistics (G.R.), Institute of Clinical Physiology, National Research Council, 56126 Pisa, Italy (literal)
Titolo
  • Total Thyroidectomy in Patients with Amiodarone-Induced Thyrotoxicosis and Severe Left Ventricular Systolic Dysfunction (literal)
Abstract
  • Objective: The objective of the study was to evaluate the effect of a total thyroidectomy on cardiac function and survival of AIT patients with severe LV systolic dysfunction. (literal)
  • Context: Patients with amiodarone-induced thyrotoxicosis (AIT) and left ventricular (LV) systolic dysfunction have a high mortality rate. Usually, medical therapy is the first choice for AIT patients, whereas the role of the thyroidectomy is unsettled. Objective: The objective of the study was to evaluate the effect of a total thyroidectomy on cardiac function and survival of AIT patients with severe LV systolic dysfunction. Design: This was a retrospective cohort study. Settings: The study was conducted at a tertiary university center. Patients: All AIT patients (n?24; nine patients with type 1 AIT, 15 patients with type 2 AIT) referred to the Department of Endocrinology and submitted to a total thyroidectomy at the Department of Surgery, both at the University of Pisa, during the years 1997-2010. Intervention: The intervention was a total thyroidectomy. MainOutcomeMeasure:LVejection fraction (EF) after the thyroidectomyandsurvival inDecember 2011 were measured. Results: All enrolled patients had previously undergone to medical treatment for AIT, as appropriate, without achieving euthyroidism. Patients with moderate to severe LV systolic dysfunction (EF?40%, group 1,n?9) or with mild systolic dysfunction(40%?EF?50%, group 2,n?5) were compared with patients with normal systolic function (EF?50%, group 3, n?10). Two months after thyroidectomy, under levothyroxine replacement therapy, LVEF improved in patients with LV systolic dysfunction, particularly in those of group 1, in whom it increased from 28.2?7.2 to 38.3?6%(P?0.007). On the contrary, LVEF did not significantly change in group 3 (from 57.1?3.0 to 59.8?6.6%, P?0.242). The meanfollow-upwas67?42 months.Nodeath occurred duringand2monthsafter surgery.Onedeath occurred in one patient of group 1, 30 months after the thyroidectomy, due to acute myocardial infarction. No patient had relevant complications of thyroidectomy. Conclusions: Total thyroidectomy, by rapidly restoring euthyroidism,mayimprove cardiac function and reduce the risk of mortality in AIT patients with severe LV dysfunction. (literal)
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