使用碘化造影剂后的心电和结构变化:纵向队列分析

IF 5.8 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Thyroid Pub Date : 2024-09-01 Epub Date: 2024-08-27 DOI:10.1089/thy.2024.0131
Kosuke Inoue, Muhammad T Bashir, Alberta L Warner, Ramin Ebrahimi, Natalia V Neverova, Jesse W Currier, Seo Young Sohn, Connie M Rhee, Martin L Lee, Angela M Leung
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引用次数: 0

摘要

背景:碘造影剂常用于放射手术,一次剂量的碘造影剂可提供正常甲状腺激素分泌每日所需剂量的几百倍。碘过量的风险包括甲状腺功能障碍,而甲状腺功能障碍与不良心脏预后有关,但目前还没有前瞻性研究对使用碘造影剂后心脏生理学的变化进行调查。本研究旨在调查碘造影剂用量与心脏电生理学和结构变化之间的纵向关系:这项纵向队列研究的对象是在选择性计算机断层扫描或冠状动脉造影术中接受碘造影剂治疗的前瞻性参与者。连续采集血清甲状腺功能检测、心电图(EKG)和经胸超声心动图(TTE),直至 36 个月。使用混合效应模型评估了使用碘造影剂后心脏电学和结构变化的趋势:结果:129 名患者(中位年龄 70 [四分位间范围:63,75]岁;98% 为男性)组成了研究组。碘暴露量的增加与 QRS 和 QTc 时间的延长以及射血分数(EF)的降低有关,在对基线值进行额外调整后,随访 EF 仍与碘暴露量有关(高碘对比组与低碘对比组相比,-4.23% [95%CI, -7.66% to -0.79%])。剂量-反应分析也显示,碘剂量越大,EF 越低;但这些趋势对所研究的心电图参数并不显著:结论:在长达 36 个月的时间里,碘对比剂用量越大,参与者的 EF 越低。还需要进一步调查,以阐明使用碘造影剂后心脏电功能和结构功能的长期趋势。
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Cardiac Electrical and Structural Changes after Iodinated Contrast Media Administration: A Longitudinal Cohort Analysis.

Background: Iodinated contrast is commonly used for radiological procedures, with one dose delivering several hundred-fold the daily requirements needed for normal thyroid hormone production. Risks of excess iodine include incident thyroid dysfunction, which is associated with adverse cardiac outcomes, yet there are no prospective studies investigating the changes in cardiac physiology following iodine contrast administration. This study was conducted to investigate the longitudinal relationships between the amount of iodinated contrast administration and changes in cardiac electrophysiology and structure. Methods: A longitudinal cohort study was conducted with prospectively enrolled participants who received iodine contrast for elective computed tomography or coronary angiography. Serum thyroid function tests, electrocardiograms (EKG), and transthoracic echocardiograms were obtained serially until 36 months. Trends of electrical and structural cardiac changes following iodine contrast administration were assessed using mixed effect models. Results: The cohort was composed of 129 patients (median age, 70 [interquartile range: 63, 75] years; 98% male). Larger amounts of iodine exposure were associated with increases in QRS and QTc durations and decreased ejection fraction (EF), and these associations were still observed for follow-up EF after additionally adjusting for baseline values (the high-iodine contrast group vs. the low-iodine contrast group, -4.23% [confidence interval, -7.66% to -0.79%]). Dose-response analyses also showed lower EF with larger amounts of iodine received; these trends were not significant for the EKG parameters studied. Conclusions: Over a period of up to 36 months, a larger amount of administered iodine contrast was associated with lower EF among participants. Further investigation is needed to elucidate the long-term trends of electrical and structural cardiac function after iodine contrast administration.

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来源期刊
Thyroid
Thyroid 医学-内分泌学与代谢
CiteScore
12.30
自引率
6.10%
发文量
195
审稿时长
6 months
期刊介绍: This authoritative journal program, including the monthly flagship journal Thyroid, Clinical Thyroidology® (monthly), and VideoEndocrinology™ (quarterly), delivers in-depth coverage on topics from clinical application and primary care, to the latest advances in diagnostic imaging and surgical techniques and technologies, designed to optimize patient care and outcomes. Thyroid is the leading, peer-reviewed resource for original articles, patient-focused reports, and translational research on thyroid cancer and all thyroid related diseases. The Journal delivers the latest findings on topics from primary care to clinical application, and is the exclusive source for the authoritative and updated American Thyroid Association (ATA) Guidelines for Managing Thyroid Disease.
期刊最新文献
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