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

Journal Article

,

1Departments of Endocrinology and Metabolism (L.T., A.M., E.M., F.B.), 56124 Pisa, Italy

Search for other works by this author on:

,

2Surgery (G.M., M.M., L.D.N., P.M.), 56124 Pisa, Italy

Search for other works by this author on:

,

4Department of Clinical and Experimental Medicine (L.B.), University of Insubria, 21100 Varese, Italy

Search for other works by this author on:

,

5Unit of Epidemiology and Biostatistics (G.R.), Institute of Clinical Physiology, National Research Council, 56126 Pisa, Italy

Search for other works by this author on:

,

1Departments of Endocrinology and Metabolism (L.T., A.M., E.M., F.B.), 56124 Pisa, Italy

Search for other works by this author on:

,

2Surgery (G.M., M.M., L.D.N., P.M.), 56124 Pisa, Italy

Search for other works by this author on:

,

2Surgery (G.M., M.M., L.D.N., P.M.), 56124 Pisa, Italy

Search for other works by this author on:

,

3Cardio-Thoracic Department (R.M.), University of Pisa, 56124 Pisa, Italy

Search for other works by this author on:

,

2Surgery (G.M., M.M., L.D.N., P.M.), 56124 Pisa, Italy

Search for other works by this author on:

,

1Departments of Endocrinology and Metabolism (L.T., A.M., E.M., F.B.), 56124 Pisa, Italy

Search for other works by this author on:

... Show more

Published:

01 October 2012

• • Article contents
  • Figures & tables
  • Video
  • Audio
  • Supplementary Data
• Cite

Cite

Luca Tomisti, Gabriele Materazzi, Luigi Bartalena, Giuseppe Rossi, Angelica Marchello, Manuela Moretti, Luigi De Napoli, Rita Mariotti, Paolo Miccoli, Enio Martino, Fausto Bogazzi, Total Thyroidectomy in Patients with Amiodarone-Induced Thyrotoxicosis and Severe Left Ventricular Systolic Dysfunction, The Journal of Clinical Endocrinology & Metabolism, Volume 97, Issue 10, 1 October 2012, Pages 3515–3521, https://doi.org/10.1210/jc.2012-1797
Close

Navbar Search Filter Mobile Enter search term Search

Abstract

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.

Main Outcome Measure:

LV ejection fraction (EF) after the thyroidectomy and survival in December 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 mean follow-up was 67 ± 42 months. No death occurred during and 2 months after surgery. One death 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, may improve cardiac function and reduce the risk of mortality in AIT patients with severe LV dysfunction.

Copyright © 2012 by The Endocrine Society

You do not currently have access to this article.

Personal account

• Sign in with email/username & password
• Get email alerts
• Save searches
• Purchase content
• Activate your purchase/trial code
• Add your ORCID iD

Get help with access

Institutional access

Access to content on Oxford Academic is often provided through institutional subscriptions and purchases. If you are a member of an institution with an active account, you may be able to access content in one of the following ways:

IP based access

Typically, access is provided across an institutional network to a range of IP addresses. This authentication occurs automatically, and it is not possible to sign out of an IP authenticated account.

Sign in through your institution

Choose this option to get remote access when outside your institution. Shibboleth/Open Athens technology is used to provide single sign-on between your institution’s website and Oxford Academic.

1. Click Sign in through your institution.
2. Select your institution from the list provided, which will take you to your institution's website to sign in.
3. When on the institution site, please use the credentials provided by your institution. Do not use an Oxford Academic personal account.
4. Following successful sign in, you will be returned to Oxford Academic.

If your institution is not listed or you cannot sign in to your institution’s website, please contact your librarian or administrator.

Sign in with a library card

Enter your library card number to sign in. If you cannot sign in, please contact your librarian.

Society Members

Society member access to a journal is achieved in one of the following ways:

Sign in through society site

Many societies offer single sign-on between the society website and Oxford Academic. If you see ‘Sign in through society site’ in the sign in pane within a journal:

1. Click Sign in through society site.
2. When on the society site, please use the credentials provided by that society. Do not use an Oxford Academic personal account.
3. Following successful sign in, you will be returned to Oxford Academic.

If you do not have a society account or have forgotten your username or password, please contact your society.

Sign in using a personal account

Some societies use Oxford Academic personal accounts to provide access to their members. See below.

Personal account

A personal account can be used to get email alerts, save searches, purchase content, and activate subscriptions.

Some societies use Oxford Academic personal accounts to provide access to their members.

Viewing your signed in accounts

Click the account icon in the top right to:

• View your signed in personal account and access account management features.
• View the institutional accounts that are providing access.

Signed in but can't access content

Oxford Academic is home to a wide variety of products. The institutional subscription may not cover the content that you are trying to access. If you believe you should have access to that content, please contact your librarian.

Institutional account management

For librarians and administrators, your personal account also provides access to institutional account management. Here you will find options to view and activate subscriptions, manage institutional settings and access options, access usage statistics, and more.

Purchase

Short-term Access

To purchase short-term access, please sign in to your personal account above.

Don't already have a personal account? Register

Total Thyroidectomy in Patients with Amiodarone-Induced Thyrotoxicosis and Severe Left Ventricular Systolic Dysfunction - 24 Hours access

EUR €38.00

GBP £33.00

USD $41.00

Rental

This article is also available for rental through DeepDyve.

Citations

Views

Altmetric

Metrics

Total Views 1,445

998 Pageviews

447 PDF Downloads

Since 1/1/2017

Citations

44 Web of Science

×

Email alerts

More on this topic

Related articles in PubMed

Citing articles via

• Latest

• Most Read

• Most Cited

More from Oxford Academic