Abstract
Myocardial performance during thyrotoxicosis (T) was evaluated by multigated radionuclide angiocardiography during graded axercise in 8 children (8-17 ys) with Graves' disease. With exercise, heart rate (HR) and systolic blood pressure (SBP) increased in all patients; left ventricular ejection fraction (LVEF) increased normally by 7 to 10% in 4 (2 male, 2 female), but did not increase significantly in 1 (male) and decreased by 3 to 8% in 3 (female). There was no significant difference in the duration of T, resting and exercise HR and SBP, or resting LVEF, between patients with normal and abnormal responses. The change in LVEF was inversely correlated with serum T4 (r= −.82, p<.02) and T3 (r= −.88, p<.05). Three abnormal and 2 normal responders were reassessed after return to euthyroid state. Resting HR and SBP were considerably lower than during T; resting LVEF was 64% ± 6. With exercise, HR and SBP rose to levels attained during the first study; LVEF increased in all patients by 7 to 23%. Our study suggests that T causes diminished LV reserve (compensated functional cardiomyopathy) which appears to be reversible. Severity of T (measured by T4 and T3 levels) may be a determining factor in the development of the functional cardiomyopathy.
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Cavallo, A., Casta, A., Fawcett, H. et al. 88 FUNCTIONAL THYROTOXIC CARDIOMYOPATHY IN CHILDREN. Pediatr Res 19, 125 (1985). https://doi.org/10.1203/00006450-198504000-00118
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DOI: https://doi.org/10.1203/00006450-198504000-00118