Features of clinical manifestations of coronary heart disease in patients with amiodarone-associated hypothyroidism

Sergej V. Chernavsky, A.V. Dorokhina, O. Artyushkevich, A. A. Stremoukhov, L.A. Kudentsova
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Abstract

Coronary heart disease (CHD) is an acute problem of modern medicine. Primarily, it is determined by the high prevalence of the disease among the working-age population, as well as by the considerable mortality and disability associated with it. Amiodarone (Am) is the drug of choice in the treatment of cardiac arrhythmias (CA), one of the frequent and threatening manifestations of CHD. Long-term use of the drug can lead to the development of primary hypothyroidism (HT), which significantly aggravates the course of cardiovascular diseases. Objective. To assess the cardiovascular system (CVS) of CHD patients with the development of amiodarone-associated hypothyroidism (AmHT). Material and methods. Analysis of case histories of 810 patients with CHD and various CA who were taking Am for sinus rhythm control was performed. The case histories were examined and a retrospective analysis was performed on the clinical course of CHD in 28 patients with AmHT before and after the development of thyreopathy. To evaluate the state of cardiovascular system the patients' complaints, objective examination data, electrocardiography (ECG) and echocardiography (EchoCG) were assessed. Results. Long-term intake of Am by patients with CHD results in primary HT in 3.4% of cases. The formation of thyreopathy significantly affects the course of the disease. Patients show a 19.6% increase in myocardial volume indices and a 22.7% decrease in myocardial contractility, with a 30.2% increase in left ventricular myocardial mass (LVMM). Conclusion. Amiodarone-associated hypothyroidism is one of the significant complications developing in patients taking the drug for a long period of time. The formation of thyreopathy in patients with CHD significantly aggravates the course of the underlying disease, which should be taken into account when prescribing treatment and dynamic monitoring
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胺碘酮相关性甲状腺功能减退患者冠心病的临床表现特点
冠心病(CHD)是现代医学的一个急症。主要是由于这种疾病在工作年龄人口中的高流行率,以及与之相关的大量死亡率和致残率。胺碘酮(Am)是治疗心律失常(CA)的首选药物,心律失常是冠心病的常见和威胁性表现之一。长期使用该药可导致原发性甲状腺功能减退症(HT)的发展,从而显著加重心血管疾病的病程。目标。评估冠心病并发胺碘酮相关性甲状腺功能减退症(AmHT)患者的心血管系统(CVS)。材料和方法。本文对810例冠心病及各类CA患者服用阿霉素控制窦性心律的病例进行分析。对28例AmHT患者发生甲状腺病变前后的冠心病临床病程进行回顾性分析。通过客观检查资料、心电图(ECG)和超声心动图(EchoCG)评估患者主诉的心血管系统状态。结果。冠心病患者长期摄入Am可导致3.4%的病例发生原发性HT。甲状腺病变的形成显著影响疾病的病程。患者心肌体积指数增加19.6%,心肌收缩力下降22.7%,左室心肌质量(LVMM)增加30.2%。结论。胺碘酮相关性甲状腺功能减退症是长期服用该药物的患者发生的重要并发症之一。冠心病患者甲状腺病变的形成明显加重了基础疾病的病程,在处方治疗和动态监测时应考虑到这一点
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