Thyroid dysfunction and electrocardiographic changes in subjects without arrhythmias: a cross-sectional study of primary healthcare subjects from Copenhagen

Bhupendar Tayal; Claus Graff; Christian Selmer; Kristian Hay Kragholm; Magnus Kihlstrom; Jonas Bille Nielsen; Anne-Marie Schjerning Olsen; Adrian Holger Pietersen; Anders G. Holst; Peter Søgaard; Christine Benn Christiansen; Jens Faber; Gunnar Hilmar Gislason; Christian Torp-Pedersen; Steen M Hansen

doi:10.1136/bmjopen-2018-023854

Thyroid dysfunction and electrocardiographic changes in subjects without arrhythmias: a cross-sectional study of primary healthcare subjects from Copenhagen

Bhupendar Tayal, Claus Graff, Christian Selmer, Kristian Hay Kragholm, Magnus Kihlstrom, Jonas Bille Nielsen, Anne-Marie Schjerning Olsen, Adrian Holger Pietersen, Anders G. Holst, Peter Søgaard, Christine Benn Christiansen, Jens Faber, Gunnar Hilmar Gislason, Christian Torp-Pedersen, Steen M Hansen

Department of Clinical Medicine

3 Citations (Scopus)

16 Downloads (Pure)

Abstract

The objective of the present study was to investigate associations of both overt and subclinical thyroid dysfunction with common ECG parameters in a large primary healthcare population. Design Cross-sectional study. Setting and participants The study population comprised of primary healthcare patients in Copenhagen, Denmark, who had a thyroid function test and an ECG recorded within 7 days of each other between 2001 and 2011. Data sources The Danish National Patient Registry was used to collect information regarding baseline characteristics and important comorbidities. Outcome measure and study groups Common ECG parameters were determined using Marquette 12SL software and were compared between the study groups. The study population was divided into five groups based on their thyroid status. Euthyroid subjects served as the reference group in all analyses. Results A total of 132 707 patients (age 52±17 years; 50% female) were included. Hyperthyroidism was significantly associated with higher heart rate and prolonged QTc interval with significant interaction with age (p<0.009) and sex (p<0.001). These associations were less pronounced for patients with higher age. Subclinical hyperthyroidism was associated with higher heart rate among females, and a similar trend was observed among males. Hypothyroidism was associated with slower heart rate and shorter QTc but only in women. Moreover, longer P-wave duration, longer PR interval and low voltage were observed in patients with both subclinical and overt hypothyroidism. However, the presence of low voltage was less pronounced with higher age (p=0.001). Conclusion Both overt and subclinical thyroid disorders were associated with significant changes in important ECG parameters. Age and gender have significant impact on the association of thyroid dysfunction particularly on heart rate and QTc interval.

Original language	English
Article number	e023854
Journal	BMJ Open
Volume	9
Number of pages	10
ISSN	2044-6055
DOIs	https://doi.org/10.1136/bmjopen-2018-023854
Publication status	Published - 1 Jun 2019

Access to Document

10.1136/bmjopen-2018-023854Licence: CC BY-NC

Thyroid dysfunction and electrocardiographic changes in subjects without arrhythmias: a cross-sectional study of primary healthcare subjects from CopenhagenFinal published version, 1.9 MBLicence: CC BY-NC

Cite this

Tayal, B., Graff, C., Selmer, C., Kragholm, K. H., Kihlstrom, M., Nielsen, J. B., Olsen, A.-M. S., Pietersen, A. H., Holst, A. G., Søgaard, P., Christiansen, C. B., Faber, J., Gislason, G. H., Torp-Pedersen, C., & Hansen, S. M. (2019). Thyroid dysfunction and electrocardiographic changes in subjects without arrhythmias: a cross-sectional study of primary healthcare subjects from Copenhagen. BMJ Open, 9, Article e023854. https://doi.org/10.1136/bmjopen-2018-023854

Tayal, B, Graff, C, Selmer, C, Kragholm, KH, Kihlstrom, M, Nielsen, JB, Olsen, A-MS, Pietersen, AH, Holst, AG, Søgaard, P, Christiansen, CB, Faber, J, Gislason, GH, Torp-Pedersen, C & Hansen, SM 2019, 'Thyroid dysfunction and electrocardiographic changes in subjects without arrhythmias: a cross-sectional study of primary healthcare subjects from Copenhagen', BMJ Open, vol. 9, e023854. https://doi.org/10.1136/bmjopen-2018-023854

@article{880263995ffc4d3692473ffdcb31abb5,

title = "Thyroid dysfunction and electrocardiographic changes in subjects without arrhythmias: a cross-sectional study of primary healthcare subjects from Copenhagen",

abstract = "The objective of the present study was to investigate associations of both overt and subclinical thyroid dysfunction with common ECG parameters in a large primary healthcare population. Design Cross-sectional study. Setting and participants The study population comprised of primary healthcare patients in Copenhagen, Denmark, who had a thyroid function test and an ECG recorded within 7 days of each other between 2001 and 2011. Data sources The Danish National Patient Registry was used to collect information regarding baseline characteristics and important comorbidities. Outcome measure and study groups Common ECG parameters were determined using Marquette 12SL software and were compared between the study groups. The study population was divided into five groups based on their thyroid status. Euthyroid subjects served as the reference group in all analyses. Results A total of 132 707 patients (age 52±17 years; 50% female) were included. Hyperthyroidism was significantly associated with higher heart rate and prolonged QTc interval with significant interaction with age (p<0.009) and sex (p<0.001). These associations were less pronounced for patients with higher age. Subclinical hyperthyroidism was associated with higher heart rate among females, and a similar trend was observed among males. Hypothyroidism was associated with slower heart rate and shorter QTc but only in women. Moreover, longer P-wave duration, longer PR interval and low voltage were observed in patients with both subclinical and overt hypothyroidism. However, the presence of low voltage was less pronounced with higher age (p=0.001). Conclusion Both overt and subclinical thyroid disorders were associated with significant changes in important ECG parameters. Age and gender have significant impact on the association of thyroid dysfunction particularly on heart rate and QTc interval.",

author = "Bhupendar Tayal and Claus Graff and Christian Selmer and Kragholm, {Kristian Hay} and Magnus Kihlstrom and Nielsen, {Jonas Bille} and Olsen, {Anne-Marie Schjerning} and Pietersen, {Adrian Holger} and Holst, {Anders G.} and Peter S{\o}gaard and Christiansen, {Christine Benn} and Jens Faber and Gislason, {Gunnar Hilmar} and Christian Torp-Pedersen and Hansen, {Steen M}",

year = "2019",

month = jun,

day = "1",

doi = "10.1136/bmjopen-2018-023854",

language = "English",

volume = "9",

journal = "BMJ Open",

issn = "2044-6055",

publisher = "BMJ Publishing Group",

}

TY - JOUR

T1 - Thyroid dysfunction and electrocardiographic changes in subjects without arrhythmias

T2 - a cross-sectional study of primary healthcare subjects from Copenhagen

AU - Tayal, Bhupendar

AU - Graff, Claus

AU - Selmer, Christian

AU - Kragholm, Kristian Hay

AU - Kihlstrom, Magnus

AU - Nielsen, Jonas Bille

AU - Olsen, Anne-Marie Schjerning

AU - Pietersen, Adrian Holger

AU - Holst, Anders G.

AU - Søgaard, Peter

AU - Christiansen, Christine Benn

AU - Faber, Jens

AU - Gislason, Gunnar Hilmar

AU - Torp-Pedersen, Christian

AU - Hansen, Steen M

PY - 2019/6/1

Y1 - 2019/6/1

N2 - The objective of the present study was to investigate associations of both overt and subclinical thyroid dysfunction with common ECG parameters in a large primary healthcare population. Design Cross-sectional study. Setting and participants The study population comprised of primary healthcare patients in Copenhagen, Denmark, who had a thyroid function test and an ECG recorded within 7 days of each other between 2001 and 2011. Data sources The Danish National Patient Registry was used to collect information regarding baseline characteristics and important comorbidities. Outcome measure and study groups Common ECG parameters were determined using Marquette 12SL software and were compared between the study groups. The study population was divided into five groups based on their thyroid status. Euthyroid subjects served as the reference group in all analyses. Results A total of 132 707 patients (age 52±17 years; 50% female) were included. Hyperthyroidism was significantly associated with higher heart rate and prolonged QTc interval with significant interaction with age (p<0.009) and sex (p<0.001). These associations were less pronounced for patients with higher age. Subclinical hyperthyroidism was associated with higher heart rate among females, and a similar trend was observed among males. Hypothyroidism was associated with slower heart rate and shorter QTc but only in women. Moreover, longer P-wave duration, longer PR interval and low voltage were observed in patients with both subclinical and overt hypothyroidism. However, the presence of low voltage was less pronounced with higher age (p=0.001). Conclusion Both overt and subclinical thyroid disorders were associated with significant changes in important ECG parameters. Age and gender have significant impact on the association of thyroid dysfunction particularly on heart rate and QTc interval.

AB - The objective of the present study was to investigate associations of both overt and subclinical thyroid dysfunction with common ECG parameters in a large primary healthcare population. Design Cross-sectional study. Setting and participants The study population comprised of primary healthcare patients in Copenhagen, Denmark, who had a thyroid function test and an ECG recorded within 7 days of each other between 2001 and 2011. Data sources The Danish National Patient Registry was used to collect information regarding baseline characteristics and important comorbidities. Outcome measure and study groups Common ECG parameters were determined using Marquette 12SL software and were compared between the study groups. The study population was divided into five groups based on their thyroid status. Euthyroid subjects served as the reference group in all analyses. Results A total of 132 707 patients (age 52±17 years; 50% female) were included. Hyperthyroidism was significantly associated with higher heart rate and prolonged QTc interval with significant interaction with age (p<0.009) and sex (p<0.001). These associations were less pronounced for patients with higher age. Subclinical hyperthyroidism was associated with higher heart rate among females, and a similar trend was observed among males. Hypothyroidism was associated with slower heart rate and shorter QTc but only in women. Moreover, longer P-wave duration, longer PR interval and low voltage were observed in patients with both subclinical and overt hypothyroidism. However, the presence of low voltage was less pronounced with higher age (p=0.001). Conclusion Both overt and subclinical thyroid disorders were associated with significant changes in important ECG parameters. Age and gender have significant impact on the association of thyroid dysfunction particularly on heart rate and QTc interval.

U2 - 10.1136/bmjopen-2018-023854

DO - 10.1136/bmjopen-2018-023854

M3 - Journal article

C2 - 31229996

SN - 2044-6055

VL - 9

JO - BMJ Open

JF - BMJ Open

M1 - e023854

ER -

Thyroid dysfunction and electrocardiographic changes in subjects without arrhythmias: a cross-sectional study of primary healthcare subjects from Copenhagen

Abstract

Access to Document

Fingerprint

Cite this