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Heart Rate Variability in Hyperthyroidism: A Systematic Review and Meta-Analysis

Author

Listed:
  • Valentin Brusseau

    (Endocrinology Diabetology and Metabolic Diseases, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, F-63000 Clermont-Ferrand, France)

  • Igor Tauveron

    (Endocrinology Diabetology and Metabolic Diseases, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, F-63000 Clermont-Ferrand, France
    Institut Génétique, Reproduction & Développement (iGReD), CNRS, INSERM, University of Clermont Auvergne, F-63000 Clermont-Ferrand, France)

  • Reza Bagheri

    (Department of Exercise Physiology, University of Isfahan, Isfahan 81746-73441, Iran)

  • Ukadike Chris Ugbolue

    (Institute for Clinical Exercise & Health Science, School of Health and Life Sciences, University of the West of Scotland, Glasgow G1 1XW, UK
    Department of Biomedical Engineering, University of Strathclyde, Glasgow G1 1XW, UK)

  • Valentin Magnon

    (Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University of Clermont Auvergne, F-63000 Clermont-Ferrand, France)

  • Jean-Baptiste Bouillon-Minois

    (Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University of Clermont Auvergne, F-63000 Clermont-Ferrand, France
    Emergency Department, CHU Clermont-Ferrand, University of Clermont Auvergne, F-63000 Clermont-Ferrand, France)

  • Valentin Navel

    (Translational Approach to Epithelial Injury and Repair, GreD, CNRS, INSERM, University of Clermont Auvergne, F-63000 Clermont-Ferrand, France
    Ophthalmology, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, F-63000 Clermont-Ferrand, France)

  • Frédéric Dutheil

    (Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University of Clermont Auvergne, F-63000 Clermont-Ferrand, France
    Occupational and Environmental Medicine, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, F-63000 Clermont-Ferrand, France)

Abstract

Objective: Cardiovascular effects of thyroid hormones may be measured through heart rate variability (HRV). We sought to determine the impact of hyperthyroidism on HRV. Design: A systematic review and meta-analysis on the impact of hyperthyroidism on HRV. Methods: PubMed, Cochrane, Embase and Google Scholar were searched until 20 August 2021 for articles reporting HRV parameters in untreated hyperthyroidism and healthy controls. Random-effects meta-analysis was stratified by degree of hyperthyroidism for each HRV parameter: RR intervals (or Normal-to-Normal intervals—NN), SDNN (standard deviation of RR intervals), RMSSD (square root of the mean difference of successive RR intervals), pNN50 (percentage of RR intervals with >50 ms of variation), total power (TP), LFnu (low-frequency normalized unit) and HFnu (high-frequency), VLF (very low-frequency), and LF/HF ratio. Results: We included 22 studies with 10,811 patients: 1002 with hyperthyroidism and 9809 healthy controls. There was a decrease in RR (effect size = −4.63, 95% CI −5.7 to −3.56), SDNN (−6.07, −7.42 to −4.71), RMSSD (−1.52, −2.18 to −0.87), pNN50 (−1.36, −1.83 to −0.88), TP (−2.05, −2.87 to −1.24), HFnu (−3.51, −4.76 to −2.26), and VLF power (−2.65, −3.74 to −1.55), and an increase in LFnu (2.66, 1.55 to 3.78) and LF/HF ratio (1.75, 1.02 to 2.48) ( p < 0.01). Most parameters had ES that was twice as high in overt compared to subclinical hyperthyroidism. Increased peripheral thyroid hormones and decreased TSH levels were associated with lower RR intervals. Conclusions: Hyperthyroidism is associated with a decreased HRV, which may be explained by the deleterious effect of thyroid hormones and TSH. The increased sympathetic and decreased parasympathetic activity may have clinical implications.

Suggested Citation

  • Valentin Brusseau & Igor Tauveron & Reza Bagheri & Ukadike Chris Ugbolue & Valentin Magnon & Jean-Baptiste Bouillon-Minois & Valentin Navel & Frédéric Dutheil, 2022. "Heart Rate Variability in Hyperthyroidism: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 19(6), pages 1-13, March.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:6:p:3606-:d:774037
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    References listed on IDEAS

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    1. Chen, Jin-Long & Shiau, Yuo-Hsien & Tseng, Yin-Jiun & Chiu, Hung-Wen & Hsiao, Tzu-Chien & Wessel, Niels & Kurths, Jürgen & Chu, Woei-Chyn, 2010. "Concurrent sympathetic activation and vagal withdrawal in hyperthyroidism: Evidence from detrended fluctuation analysis of heart rate variability," Physica A: Statistical Mechanics and its Applications, Elsevier, vol. 389(9), pages 1861-1868.
    2. Cédric Benoist d’Azy & Bruno Pereira & Geraldine Naughton & Frédéric Chiambaretta & Frédéric Dutheil, 2016. "Antibioprophylaxis in Prevention of Endophthalmitis in Intravitreal Injection: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-12, June.
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    Cited by:

    1. Riccardo Dore & Laura Watson & Stefanie Hollidge & Christin Krause & Sarah Christine Sentis & Rebecca Oelkrug & Cathleen Geißler & Kornelia Johann & Mehdi Pedaran & Greta Lyons & Nuria Lopez-Alcantara, 2023. "Resistance to thyroid hormone induced tachycardia in RTHα syndrome," Nature Communications, Nature, vol. 14(1), pages 1-11, December.
    2. Hangjin Byeon & Yesol Moon & Seoeun Lee & Gwang-Ic Son & Eunil Lee, 2023. "Effect of the Marine Exercise Retreat Program on Thyroid-Related Hormones in Middle-Aged Euthyroid Women," IJERPH, MDPI, vol. 20(2), pages 1-17, January.

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