Key result
Thyroid dysfunction is linked to distinct ECG abnormalities, with attenuated changes in older patients.
Why the study?
The study was conducted to investigate the associations of both overt and subclinical thyroid dysfunction with common ECG parameters in a large primary healthcare population.
Does thyroid dysfunction affect common ECG parameters in a primary healthcare population?
Cross-Sectional (n=132,707)
Does thyroid dysfunction affect common ECG parameters in a primary healthcare population?
Both overt and subclinical thyroid dysfunction are associated with significant changes in ECG parameters, including heart rate, QTc interval, and low voltage, though these effects are less pronounced in older patients.
Answers are grounded in this paper and cite their sources.
May inform ECG interpretation in thyroid dysfunction; extends associations to primary care but leaves clinical impact open.
OBJECTIVE: The objective of the present study was to investigate associations of both overt and subclinical thyroid dysfunction with common ECG parameters in a large primary healthcare population. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: The study population comprised of primary healthcare patients in Copenhagen, Denmark, who had a thyroid function test and an ECG recorded within 7 days of each other between 2001 and 2011. DATA SOURCES: The Danish National Patient Registry was used to collect information regarding baseline characteristics and important comorbidities. OUTCOME MEASURE AND STUDY GROUPS: Common ECG parameters were determined using Marquette 12SL software and were compared between the study groups. The study population was divided into five groups based on their thyroid status. Euthyroid subjects served as the reference group in all analyses. RESULTS: A total of 132 707 patients (age 52±17 years; 50% female) were included. Hyperthyroidism was significantly associated with higher heart rate and prolonged QTc interval with significant interaction with age (p<0.009) and sex (p<0.001). These associations were less pronounced for patients with higher age. Subclinical hyperthyroidism was associated with higher heart rate among females, and a similar trend was observed among males. Hypothyroidism was associated with slower heart rate and shorter QTc but only in women. Moreover, longer P-wave duration, longer PR interval and low voltage were observed in patients with both subclinical and overt hypothyroidism. However, the presence of low voltage was less pronounced with higher age (p=0.001). CONCLUSION: Both overt and subclinical thyroid disorders were associated with significant changes in important ECG parameters. Age and gender have significant impact on the association of thyroid dysfunction particularly on heart rate and QTc interval.
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Tayal et al. (2019) conducted a cross-sectional in Thyroid dysfunction (n=132,707). Thyroid dysfunction (overt and subclinical) vs. Euthyroid subjects was evaluated on PR interval (overt hypothyroidism vs euthyroid) (MD 6.61, 95% CI 4.30 to 8.92). Overt and subclinical thyroid dysfunction were associated with significant changes in ECG parameters, including higher heart rate and prolonged QTc in hyperthyroidism, though these effects were less pronounced in older patients.
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