Key result
Thyroid surgery in patients with hyperthyroidism significantly shortened the Tp-e/QTc ratio from 0.21 to 0.19 (P<0.001) at six months.
Why the study?
Prolonged Tp-e/QTc is related to an increased risk of arrhythmias and cardiac mortality, but the assessment of Tp-e interval and Tp-e/QT ratio before and after thyroid surgery in hyperthyroidism required appraisal.
Does thyroid surgery improve ventricular repolarization parameters (Tp-e interval and Tp-e/QT ratio) in patients with hyperthyroidism?
Cohort (n=65)
No
Does thyroid surgery improve ventricular repolarization parameters (Tp-e interval and Tp-e/QT ratio) in patients with hyperthyroidism?
Thyroid surgery in patients with hyperthyroidism significantly shortens the Tp-e interval and Tp-e/QTc ratio, suggesting an improvement in ventricular repolarization and potentially a reduced risk of ventricular arrhythmias.
May indicate reduced repolarization heterogeneity after thyroidectomy in hyperthyroidism; leaves open whether this lowers arrhythmia risk.
BACKGROUND: Ventricular repolarisation is assessed using the Tp-e interval and QT interval corrected by the heart rate (QTc) via an electrocardiogram (ECG). Prolonged Tp-e/QTc is related with an increased risk of arrhythmias and cardiac mortality. OBJECTIVE: This study was conducted at a single centre in collaboration with general surgery and cardiology clinics. We aimed to appraise the assessment of Tp-e interval and Tp-e/QT ratio in patients with hyperthyroidism before and after thyroid surgery. METHODS: Totally 65 patients with hyperthyroidism before and after thyroid surgery were enrolled in our study. In presurgical hospitalisation and six months after the thyroid surgery, we measured the electrocardiographic parameters again on same patients. All subjects who were investigated in this study were in sinus rhythm. Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were measured from the 12-lead electrocardiogram. RESULTS: Heart rate (P = .073), QT interval (P = .432) and QTc interval (P = .179) were similar before and after thyroid surgery. Tp-e interval (84.6 ± 13.1 vs 77.2 ± 10.9; P = .031), Tp-e/QT ratio (0.23 ± 0.04 vs 0.21 ± 0.04; P < .001), Tp-e/QTc ratio (0.21 ± 0.04 vs 0.19 ± 0.03; P < .001) and QTc dispersion (52.4 ± 7.2 vs 48.4 ± 7.4; P < .001) were significantly different before and after thyroid surgery. In correlation analysis, there was a significant correlation between preprocedural Tp-e/QTc ratio and preprocedural fT4 in patients with hyperthyroidism (r = 0.275, P = .026). CONCLUSION: Our study demonstrated that Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were shortened in patients with hyperthyroidism after thyroid surgery than before procedure. This study is considerable to display that hyperthyroidism may have a negative effect on cardiac conduction system, which potentially may induce formation of ventricular arrhythmias.
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Aydın et al. (2021) conducted a cohort in Hyperthyroidism (n=65). Thyroid surgery vs. Before surgery (baseline) was evaluated on Tp-e/QTc ratio (p=<.001). Thyroid surgery in patients with hyperthyroidism significantly shortened the Tp-e/QTc ratio from 0.21 to 0.19 (P<0.001) at six months.
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