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cardiothyreosis: Risk Factors and Clinical Profile

Open Journal of Internal Medicine 2017年第1期7卷 1-11页

作者： D. Diédhiou D. Sow M. M. Lèye I. M. Diallo M. Bodian M. A. Ndoure E. Bouary M. Ndour Mbaye A. Sarr S. N. Diop Department of Internal Medicine Abass Ndao Hospital Center Cheikh Anta Diop University Dakar Senegal Department of Preventive Medicine and Public Health Cheikh Anta Diop University Dakar Senegal Cardiology Department Aristide LeDantec Hospital Center Cheikh Anta Diop University Dakar Senegal

Introduction: The diagnosis of cardiothyreosis is based on the presence of the association of thyrotoxicosis and various cardiovascular disorders such as heart failure, coronary artery disease, rhythm or conduction disorders. Data are limited on this entity in Africa which a frequency of 10% to 33% among hyperthyroidism. We aimed to evaluate these risk factors and describe its diagnostic features in Abass Ndao Hospital Center of Dakar. Patients and Methods: It was a descriptive and analytical cross sectional study conducted from 1 January 2010 to 31 December 2014, including all cases of hyperthyroidism with cardiothyreosis. Epidemiological data, cardiovascular risk factors and characteristics of cardiothyreosis were evaluated. Results: 150 cases of cardiothyreosis were collected with a prevalence of 9.8% among 1517 hyperthyroidism. Mean age was 42.6 ± 9 years and sex ratio 0.33. It was a Graves’ disease in 82.2% of cases. Time limit of cardiothyreosis appearance was 27 ± 41 months and cardiothyreosis was inaugural in 46.6%. Electrocardiogram showed an arrhythmia (38.7%), coronary insufficiency (8%). On echocardiography assessment, impairment of left ventricular ejection fraction (LVEF) was found in 18.5%. Of these, it was 34.7% of arrhythmia, 8.6% of coronary insufficiency and 65.2% of heart failure. Among patients with pulmonary artery hypertension (PAH) (57.3%), there were a rhythm disorder (38%), coronary insufficiency (5.6%) and heart failure (78.8%). Female gender was the only one at risk of arrhythmia (p = 0.01) and impaired of left ventricular ejection fraction (p = 0.007). Existence of a free T4 > 50 pmol/L (p = 0.05) were only at risk of developing pulmonary artery hypertension. Conclusion: cardiothyreosis is a significant complication. These discovery methods call for more early diagnosis and appropriate treatment. Female gender and severity of thyrotoxicosis seem to precipitate the clinical picture. Echocardiography remains an indispensable tool for asses

关键词： cardiothyreosis Risk Factors Clinical Profile Senegal

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cardiothyreosis in Sub-Saharan Africa (Benin)

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Open Journal of Endocrine and Metabolic Diseases 2019年第11期9卷 119-126页

作者： Annelie Kerekou-Hode Philippe Adjagba Samiratou Mama Bio Aude Gaou University Clinic of Endocrinology National University Hospital Center Hubert Koutoukou Manga Cotonou Benin University Cardiology Clinic National University Hospital Center Hubert Koutoukou Manga Cotonou Benin

This is a retrospective study over a 5-year period from January 1, 2013 to December 31, 2018. The diagnosis of cardiothyreosis was retained before clinical signs of hyperthyroidism confirmed to biology by an elevation of T4 and a collapse of ultrasensitive TSH associated with at least one of the following heart failure: insufficiency heart disease, coronary heart failure, rhythm disorder. Sociodemographic, anthropometric, clinical and paraclinical data were analyzed from medical records. Follow-up was evaluated over a period of 6 months to one year after being put on synthetic antithyroids. Results: Of 72 patients seen with hyperthyroidism conditions during the period, we identified 10 cases of cardiothyresis at the departments of Endocrinology and Cardiology of the CNHU/HKM Teaching hospital of Cotonou, Benin. The frequency of cardiothyreosis among hyperthyroidsis was 13.88%. The mean-age for our patients was 50.9 years with bounds from 29 to 79 years. The predominance was female, 8 women for 2 men. A clinical background of high blood pressure is founded in 6/10 patients;4/10 had a history of hyperthyroidism. All patients had heart failure associated with complete arrhythmia by atrial fibrillation in 6 patients. The multi-modular goiter was found in 5/10 of the patients, the vascular goiter 5/10. Synthetic antithyroids, hygienic-dietary measures and a specific treatment for heart failure were used. The average length of hospital’s stay was 7 days. Immediate development is satisfactory with euthyroidism in all patients and improved functional signs. Conclusion: cardiothyreosis is infrequent in Cotonou. This is a serious complication of hyperthyroidism, which is expensive to manage. Hence the need for early diagnosis and effective treatment of hyperthyroidism.

关键词： Hyperthyroidism cardiothyreosis Africa

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