Value of ultrasonic velocity vector imaging in assessing the motion abnormality of the myocardial segment of hyperthyroid heart disease / 中国医学装备

Objective:To explore the value of ultrasonic velocity vector imaging(VVI)in assessing motion abnormality of myocardial segment of hyperthyroid heart disease.Methods:A total of 76 patients with hyperthyroid heart disease who admitted to hospital from August 2019 to August 2021 were selected.According to the damage degree of ascending aorta of patients,30 patients whose inner diameter of ascending aorta was greater than 30 mm were included in the"inner diameter>30mm"group,and 46 patients whose inner diameter of ascending aorta was less than 30 mm were included in the"inner diameter<30mm"group.Additionally,40 healthy individuals who underwent physical examinations during the same period were selected as the healthy control group.All subjects underwent routine echocardiography examination,and the images were imported into the velocity vector imaging(VVI)workstation.And then,the clear and standard two-dimensional grayscale dynamic images were selected to conduct analysis.The left ventricle was tracked and analyzed,and the left ventricular long axis,the apical four chamber,and the velocity of reaching peak value,the time of 50%velocity and the time of 75%velocity of longitudinal myocardial movement of 18 segments of two chambers,as well as the mitral valve level of short axis,the velocity of reaching peak value of reaching peak value,the time of 50%velocity and the time of 75%velocity of radial myocardial movement of 12 segments of horizontal section of papillary muscle,of three cardiac cycles were stored and recorded.Results:There were significant differences in the time to peak of longitudinal contraction at the basal segment and middle segment of left ventricular lateral wall,and the basal segment of front wall,the basal segment,middle segment and apical segment of inferior wall,as well as the basal segment,middle segment and apical segment of posterior wall among three groups(F=45.02,23.19,8.70,19.82,16.17,18.07,36.85,48.65,36.64,P<0.05),respectively.There were significant differences in the velocity and time of reaching peak value of the radial contraction of the levels of papillary muscle and mitral valve of short axis of left ventricular inferior wall among the three groups(F=15.44,40.35,P<0.001),respectively.Conclusion:VVI technique can accurately detect the subtle changes of the synchronization of myocardial systolic motion of left ventricular short axis and long axis of patients with hyperthyroid heart disease,which has higher application value in assessing the abnormalities of myocardial segmental motion of patients with hyperthyroid heart disease.

CaMKII inhibition protects against hyperthyroid arrhythmias and adverse myocardial remodeling.

Hyperthyroidism can potentiate arrhythmias and cardiac hypertrophy, whereas Ca2+/calmodulin-dependent kinase II (CaMKII) promotes maladaptive myocardial remodeling. However, it remains unclear whether CaMKII contributes to the progression of hyperthyroid heart disease (HHD). This study demonstrated that CaMKII inhibition can relieve adverse myocardial remodeling and reduce sinus tachycardia, isoproterenol-induced atrial fibrillation, and ventricular arrhythmias in hyperthyroid mice with preserved heart function. Hyperthyroid cardiac hypertrophy was promoted by CaMKII upregulation-induced HDAC4/MEF2a activation. Briefly, CaMKII inhibition benefits HHD management greatly in mice by preventing arrhythmias and maladaptive remodeling.

Study of left atrial volume and function by real-time three-dimensional echocardiography between hyperthyroidism and hyperthyroid heart disease / 中华超声影像学杂志

Objective:To explore the application value of real-time three-dimensional echocardiography (RT-3DE) in evaluating the characteristics and regularities of left atrial volume and function changes in patients with hyperthyroidism and hyperthyroid heart disease.Methods:Fifty-six patients who were diagnosed with hyperthyroidism and hyperthyroid heart disease without treatments in Henan Provincial People′s Hospital from March 2020 to September 2020 were selected. They were divided into hyperthyroidism group(30 patients) and hyperthyroid heart disease group (26 patients). Another 30 healthy volunteers were selected as the control group. The following parameters were obtained by RT-3DE left atrial automatic quantification technology, left atrial minimum, maximum, presystolic volume index(LAVImin, LAVImax, LAVIpreA), left atrial passive, active emptying volume index and stroke volume index (LAVIp, LAVIa, LAVIEV), left atrial passive, active, total ejection fraction(LApEF, LAaEF, LAEF), during left ventricular systole, early diastole, late diastole left atrial longitudinal strain (LASr, LAScd, LASct) and circumferential strain (LASr-c, LAScd-c, LASct-c). The differences of the above parameters between the two groups were compared.Results:Compared with the control group, LAVImax, LAVIpreA, LAaEF, LAVIEV, LAVIa, LASr, LASct-c increased and LApEF decreased in the hyperthyroidism group (all P<0.05). While, LAVImin, LAVImax, LAVIpreA and LAVIEV increased, and LAaEF, LApEF, LAEF, LASct, LAScd-c and LASr-c decreased in hyperthyroid heart disease group(all P<0.05). Compared with the hyperthyroidism group, LAVImin, LAVImax and LAVIpreA in hyperthyroid heart disease group were further increased, while LAEF, LAaEF, LASr, LASr-c, LASct, LASct-c and LAScd-c were decreased (all P<0.05). LAEF were positively correlated with LASr and LASr-c ( r=0.617, 0.837; all P<0.01), LApEF were positively correlated with LAScd and LAScd-c ( r=0.620, 0.800, all P<0.01), LAaEF were positively correlated with LASct and LASct-c ( r=0.680, 0.727; all P<0.01). Conclusions:In the patients with hyperthyroidism, the left atrial reserve and systolic function are increased, which are still in the compensation stage, and the pipeline function is decreased. The left atrial reserve, pipeline and systolic function in the hyperthyroid heart disease patients are all decreased, and the pipeline function may be impaired earlier than the systolic and reserve function.

Effects of thyroid hormones on cardiac function in mice by inducing expression of B-cell activating factor in cardiomyocytes / 医学研究生学报

Objective　High levels of triiodothyronine (T3) can lead to hyperthyroid heart disease, but its mechanism is unclear. This study aims to investigate the effects of T3 on the expression of B-cell activating factor (BAFF) in cardiomyocytes and to explore its possible role in the pathogenesis of hyperthyroid heart disease.　Methods　Sixty healthy C57BL/6J mice were selected and randomly divided into two groups: the experimental group and the control group. The experimental group received intraperitoneal injection of T3 at 5 μg/ml, one time/d, for 42 consecutive days. The concentrations of serum T3 and tetraiodothyronine (T4) were detected by radioimmunoassay; ELISA was used to determine BAFF expression in peripheral blood, and the cardiac index and the transverse diameter of myocardial cells in each group were determined. Immunohistochemistry and Western blot were used to detect the expression of BAFF protein in myocardium and of myocardial tumor necrosis factor-α (TNF-α) protein; the expression of BAFF mRNA in myocardium was detected by Real-Time PCR; flow cytometry (FCM) was used to detect changes in the proportion of B-cells in the heart.　Results　Compared with the control group, the serum T3 concentration, cardiac index, BAFF and myocardial cell transverse diameter of the experimental group significantly increased (P<0.05), and the T4 concentration decreased (P<0.05). Under the light microscope, the cardiomyocytes of the control group were normal, while those of the experimental group were hypertrophied and disordered in structure. Compared with the control group (0.765±0.164), BAFF protein expression significantly increased in the experimental group (1.865±0.290) (P<0.05). Compared with the control group (0.537±0.089), the expression of TNF-α protein significantly increased in the experimental group (0.737±0.065) (P<0.05). Correlation analysis of T3 with BAFF gene expression in cardiomyocytes and BAFF level in peripheral blood showed that T3 was positively correlated with both the former with a correlation coefficient of 0.637 (P<0.01) and the latter with 0.778 (P<0.01). For FCM, compared with the control group [(12.40±1.09)%], the proportion of myocardial B-cells increased in the experimental group [(16.12±0.631)%] (P<0.05).　Conclusion　High concentration of T3 can promote the expression of BAFF in myocardial cells and lead to the activation of B-cells, thus increasing the inflammatory response and leading to myocardial hypertrophy.

Effects of thyroid hormone on myocardial T-type calcium channels at mRNA and protein levels in rats / 中国病理生理杂志

AIM:To observe the effect of thyroxine on the expression of T-type calcium channels Cav3. 1, Cav3. 2 and Cav3. 3 in rat myocardium, and to explore the possible biological mechanism between the changes of the ex-pression of T-type calcium channels and the arrhythmia in hyperthyroid heart disease. METHODS:Healthy SD rats (n=20) were randomly divided into normal control group (n=10) and hyperthyroid heart disease group (n=10). The animal model was established by intraperitoneal injection of levothyroxine for 35 d. The contents of T3 and T4 in serum, the heart-to-body weight ratio, the diameter of cardiac myocytes and electrocardiograph were measured to evaluate hyperthyroid heart disease. Moreover, the mRNA and protein expression levels of T-type calcium channels in the myocardium were measured by RT-PCR, immunohistochemistry and Western blot. RESULTS:After intraperitoneal injection of levothyroxine for 35 d, compared with the normal control group, the serum contents of T3 and T4, the heart-to-body weight ratio and the diameter of cardiac myocytes were significantly increased in hyperthyroid heart disease group (P<0.05), and arrhythmia occurred in hyperthyroid heart disease group. By immunohistochemistry and Western blot, the protein expression of Cav3. 1 in-creased significantly (P<0.05), while the protein expression of Cav3.2 decreased significantly (P<0.01). However, no change of the Cav3. 3 protein was observed. The results of RT-PCR were the same as immunohistochemistry and Western blot. CONCLUSION:Thyroxine promotes the expression of Cav3. 1 in the myocardium but inhibits the expression of Cav3. 2 at mRNA and protein levels, which might be involved in arrhythmia in hyperthyroid heart disease.

Characteristics of hyperthyroid heart disease and radioiodine-131 treatment strategy / 实用医学杂志

Objective To discuss the clinical characteristics of hyperthyroid heart disease(HHD)and ex-plore the strategy to guarantee radioiodine-131 therapy(RAI)safety. Methods Clinical data and treatment regi-mens of 40 HHD patients admitted into our department from 2012-2016 were analyzed. Common complications as atrial fibrillation,heart failure,liver damage incidences and their characteristics were concluded. Curative effects of radioiodine-131 was evaluated. Results The incidence of atrial fibrillation(AF)was 45.0%. Heart failure (HF)of left ventricular ejection fraction(LVEF)was 80.0%.Severity of HF was accompanied with serum brain na-triuretic peptide(BNP)increase and LVEF decrease.Liver function was moderate-medium impaired(61.5%).De-gree of HF was positively correlated with direct bilirubinhe(R = 0.390,P = 0.012). The RAI one-dose cure rate for hyperthyroidism was 77.5%.ATD use before RAI has no effect on the cure rate. Four patients who can′t be treated with ATD deteriorated after RAI,two of them died because of seriously infection and HF,the other two re-covered with saturated solution of potassium iodide or lithium. Conclusion HHD treatment should be made fa-miliar. ATD before RAI treatment can avoid thyroid function impairment. If anti-thyroid medication can not be used on patients,glucocorticoids,saturated solution of potassium iodide or lithium can be applied according to the patients′conditions.

Disturbed expression and distribution of myocardial connexin 43 in sudden death patients with hyperthyroid heart disease.

This study aimed to investigate the relationship between the expression and distribution of myocardial connexin 43 (Cx43) in the left ventricle and the incidence of sudden death due to hyperthyroid heart disease. Total 27 autopsy cases were selected from the Pathology Department of Medical School, Yangtze University from 2009 to 2014. The cases were divided into three groups (n=9): Experimental group, 6 males and 3 females, age range 20-57 years old, suddenly died of hyperthyroid heart disease; Hyperthyroid group, 7 males and 2 females, age range 27-63 years old; Control group, 5 males and 4 females, age range 27-49 years old. After pathological examination, Cx43 in the left ventricular muscle of each case was detected with immunohistochemical staining. In experimental group, Cx43 positive staining was found in the cytoplasm or side-side connection of ventricular myocardial cell, and the positive area and average optical density of Cx43 positive particles significantly decreased. In hyperthyroid group, average optical density of Cx43 positive particles decreased. In control group, Cx43 positive staining was found in the intercalated disc. In conclusion, the expression of myocardial Cx43 significantly decreased in sudden death patients with hyperthyroid heart disease. Our findings suggest that decreased expression of Cx43 may be related to sudden death of hyperthyroid heart disease.

Correlation Analysis of Serum Thyroid Hormone NT-proBNP in Older Adults / 现代检验医学杂志

Objective To discuss the aged people N-terminal pro-B-type natriuretic peptide (NT-proBNP)changes in thyroid function disorder and its correlation.Methods With electrochemical luminescence analyzer,detected serum NT-proBNP lev-el 38 patients with hyperthyroid heart disease,68 patients with hyperthyroidism,31 patients with hypothyroidism,and 43 ca-ses of healthy controls.Compared each groupserum NT-proBNP level of older population with middle-aged people,and anal-ysied the correlation.Results The serum NT-proBNP level of Hyperthyroidism heart group,hyperthyroidism,hypothyroid-ism group and normal control group were 827.61±626.13,107.18±54.46,162.94±134.14,68.76±39.21 pg/ml,respec-tively.The serum level of HT-pro BNP.Hyperthyroidism group,hyperthyroidism,hypothyroidism group compared with nor-mal control group,there were statistically significan(t = 7.458,4.312,3.794,P = 0.000,0.000,0.001).Hyperthyroidism heart,hypothyroidism with hyperthyroidism group serum level of NT-proBNP comparison there was statistical significance(t=7.078,2.232;P = 0.000,0.032).Hyperthyroidism heartgroup,hypothyroidism group and normal control group older population was higher than the level of serum NT-proBNP middle-aged,difference was statistically significant (t=-3.216,-2.510,-2.653;P =0.007,0.016,0.014).Hyperthyroidism group of elderly serum NT-proBNP level higher than that of middle-aged people,but there was no statistically significant difference (t=-0.140,P =0.890).Multiple regression analy-sis in hyperthyroidism group serum levels of NT-proBNP and FT4 had positive correlation (r=0.224,P =0.033)and hypo-thyroidismgroup serum levels of NT-proBNP and T3 had negative correlation (r=-0.363,P =0.022).Conclusion Thy-roid dysfunction in elderly people for the level of serum NT-proBNP had significant influence.Auxiliary disgnosis and cura-tive effect observation of the serum level of NT-proBNP in people with different thyroid functional status has certain clinical value.

Clinical analysis of 40 cases with hyperthyroid heart disease / 中国综合临床

Objective To analyze the age of onset,duration and chnical characteristics of hyperthyroid heart disease and to investigate its pathogenesis,diagnosis and treatment.Methods Forty patients were selected as our subjects.The information of clinical symptoms,assistant examinations,diagnosis and treatment were collected.Results After comprehensive treatment,39 patients recovered and one patient died of complication pulmonary infection.Conclusion The key to hyperthyroid heart disease is early diagnosis and positive treatment and then reduce the morbidity and mortality of cardiovascular complications.

Analysis of hyperthyroid heart disease by treatment with iodine-131 radioisotopes / 中国基层医药

Objective To analyze the effect of iodine-131I in the treatment of patients with hyperthyroid heart disease(HHD).Methods The clinical materials and therapeutic effect by 131 I were reviewed in 100 patients with HDD.Results The heal rate of hyperthyroidism and HHD were 82.3％,86.5％ in treatment group,and were higher than that of the control group (69.0％ and 76.2％ ) ( x2 =3.80,3.83,P ＜ 0.05 ) ; HHD with atrial fibrillation was 65.0％,average cardioversion after 131I treatment was 74.4％ after the treatment by 131I;The LVEDD、LVESD、LVEDV and HR after 131 I treatment were lower compared with before treatment ( all P ＜ 0.05 ),SV and EF were increased ( all P ＜ 0.01 ).Conclusion 131I treatment in patients with HHD,can significantly improve the efficacy of a heart disease