Vol. 2, Issue 8 (2015)
Original Article - Study of Cardiovascular Manifestations in Patients of Hypothyroidism with Special Reference to TMT (Tread Mill Test)
Author(s): Sanjay Dhawale, Rakesh Gaharwar, Satyam Singh Jayant
Abstract: Aims And Objectives--To study TMT changes in patients of hypothyroidism, to study clinical manifestations, thyroid hormone level and duration of hypothyroidism with TMT changes. To study lipid profile, body mass index in patients of hypothyroidism with TMT changes. Material And Methods - The present study was conducted in Department of Medicine, J A group of hospital, G.R. Medical College, Gwalior (M.P.).The present study is a cross sectional study, conducted over a period between September 2011 to November 2012 on the patients of hypothyroidism without history of coronary artery disease. Total of 100 patients were included in the study. Results- In present study 20% were males and 80% were females, maximum cases 36% were in 51-60 yrs of age group. Most common symptoms was lethargy followed by facial puffiness. 39% of patients were overweight and 10% was obese. In 84% cases there were normal resting ECG and 16% cases had abnormal ECG. Most common abnormalities were bradycardia 10%, low voltage complex 7%, RBBB 7%, ST-T changes (nonspecific) 5% and VPC's 4%. In 100 of patients, TMT was positive in 12% of cases and negative in 88% of cases. Out of 12 TMT positive patients, serum TSH value >10iU/ml was present in 11 (91%) of patients and only 1 (8.3%) had serum TSH values <10iU/ml. The characteristics of patients with TMT positive and negative group compared and it was seen the group varied significantly (p<0.05) with respect to their average BMI, average Free T4, average total cholesterol, average LDL, average triglyceride and average diastolic blood pressure. Majority of TMT positive patients (58.3%) had normal resting ECG and 41.7% TMT positive patients had abnormal resting ECG but in this study we found that if resting ECG was showing nonspecific ST-T changes chances of TMT positive in increased. In present study hypothyroidism was significantly associated with TMT positivity and was more common in overt hypothyroidism than subclinical hypothyroidism. Conclusion- In this study, it was concluded that TMT was significantly positive in patients of hypothyroidism. However chances of TMT positivity increase when resting ECG especially had nonspecific ST-T changes and VPC's. The prevalence of TMT positive in hypothyroidism is likely when patients had dyslipidemia, high BMI (overweight or obese) diastolic hypertension, FT4 level deficiency.