HYPERTHYROIDISM AND PULMONARY-HYPERTENSION

Objectives. To identify patients with hyperthyroidism and coincidental pulmonary hypertension and to document reversibility of pulmonary hyp ertension after treatment of hyperthyroidism. Design. Patients with hy perthyroidism referred for transthoracal echocardiography for any reas on that showed elevated pulmonary arterial pressures were collected. A fter therapy for the thyreotoxic state with documented normalization o f thyroid hormone (fT4), pulmonary arterial pressure was measured agai n noninvasively. Setting. An out-patient tertiary referral centre. Sub jects. The medical records were used to identify, retrospectively pati ents with hyperthyroidism and pulmonary hypertension over a three-year period (April 1993 to April 1996). Interventions and main outcome mea sures. Systolic pulmonary artery pressure (PAPs) was determined by add ing up right ventricular systolic pressure (RVSP) and mean right atria l pressure (RAP) measured by continuous-wave Doppler echocardiography according to standard techniques. All patients were treated for hypert hyroidism to normal fT4 levels. After successful therapy, Doppler echo cardiography was repeated. Results. Four patients with pulmonary hyper tension showing elevated PAPs of 40 +/- 11 mmHg were identified. After therapy, PAPs decreased in all patients to a mean of 25 +/- 6 mmHg. C onclusion. The observation of four patients with pulmonary hypertensio n and hyperthyroidism is striking and suggests a possible pathogenetic link of these disorders.