OCCULT THYROTOXICOSIS - CORRECTABLE CAUSE OF IDIOPATHIC ATRIAL-FIBRILLATION
OCCULT THYROTOXICOSIS - CORRECTABLE CAUSE OF IDIOPATHIC ATRIAL-FIBRILLATION
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DOI：
10.1016/0002-9149(79)90243-1
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发表时间：
1979-01-01
影响因子：
2.8
通讯作者：
TOFT, AD
中科院分区：
文献类型：
--
作者：
FORFAR, JC;MILLER, HC;TOFT, AD
研究人员连续测量了 75 名因无明显心血管原因的房颤而到心脏病诊所就诊的患者的血清总甲状腺素、三碘甲状腺原氨酸和促甲状腺素对促甲状腺素释放激素的反应。 10 名患者（13%）发现血清促甲状腺素对促甲状腺素释放激素缺乏反应，表明存在甲状腺毒症，但并非所有患者的血清甲状腺激素水平均升高。这 10 名患者主要是男性，没有甲状腺毒症的临床症状，闪烁扫描显示有相对较多的不可触及的自主甲状腺结节。 10 名患者中有 8 名在使用 131 碘或卡比马唑治疗后自发或直流电复律后恢复到稳定窦性心律。临床上隐匿性甲状腺毒症似乎只能通过促甲状腺素释放激素测试来一致地识别，并且是相当一部分患者中“特发性”心房颤动的原因。
Serum total thyroxine, triiodothyronine and thyrotropin response to thyrotropin-releasing hormone were measured in 75 consecutive patients presenting to a cardiology clinic with atrial fibrillation with no obvious cardiovascular cause. A lack of response of serum thyrotropin to thyrotropin-releasing hormone, indicative of thyrotoxicosis, was found in 10 patients (13 percent), not all of whom had raised serum thyroid hormone levels. These 10 patients were predominantly male, had no clinical signs of thyrotoxicosis and a relative excess of nonpalpable autonomous thyroid nodules demonstrated with scintigraphy. Eight of the 10 patients had reversion to stable sinus rhythm after treatment with iodine-131 or carbimazole, either spontaneously or after direct current cardioversion. It would appear that clinically occult thyrotoxicosis can be identified consistently only with the thyrotropin-releasing hormone test and is the cause of “idiopathic” atrial fibrillation in a significant proportion of patients.