Endocrine Abstracts

Cardiovascular dysfunction (CVD) is a well recognized complication in patients with hyperthyroidism and is the major cause of mortality. To date there has been no studies which had clearly evaluated the CVD and its recovery pattern between patients with Graves and Toxic multi nodular goitre(TMNG). Hence we intended to compare treatment outcomes in patients with Graves and TMNG. Patients with hyperthyroidism were grouped into, Group 1 [n=133, age<60 years, proven Graves, Group 2[n=64, age <60 years, proven TMNG] were evaluated with 2D Echocardiography, at the time of diagnosis(Point A), after achieving euthyroidism(Point B) with anti-thyroid drugs and 6 months after achieving euthyroidism (Point C). 40 patients(Group 3), age<60 years, with nontoxic benign thyroid nodules served as controls. All groups were age and sex matched. At point A, CVD was evident in 88/133(66.2%) in Group 1 and 39/64(60.9%) in Group 2. At Point B improvement in CVD occurred in 55/88(62.5%) in Group 1and 22/39(56.4%) in Group 2. At Point C dramatic improvement in CVD occurred in 82/88(93.1%) in Group 1, whereas only 28/39(71.7%) improved in Group 2. Though incidence of CVD was more in group I the improvements in dysfunction parameters were more pronounced in group I after treatment. At Point C there was a significant decrease in all the cardiac dysfunction parameters in Group 1 whereas the same was not observed in Group 2 patients (Table1). Cardiac dysfunction parameters improved significantly in patients with Graves after treatment than in patients with Toxic MNG and hence those patients with Toxic MNGs should be treated more cautiously owing to the increased morbidity due to cardiovascular dysfunction.