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Mitral kapak prolapsusu olan hastalarda tiroid fonksiyon testlerinin değerlendirilmesi

Evaluation of thyroid function tests in patients with mitral valve prolapse

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Abstract (2. Language): 
Objective: The thyroid gland and the heart share a close relationship arising in embryology. In ontogeny, the thyroid and heart anlage migrate together. The close physiological relationship is affirmed by predictable changes in cardiovascular function across the entire range of thyroid disease states. The prevalence of MVP is significantly elevated in Graves' disease and chronic lymphocytic thyroiditis, but not in toxic multinoduler goiter. No studies have previously evaluated thyroid function tests in patients with MVP in Turkey. The main objective of this study was to evaluate the thyroid function tests in patients with mitral valve prolapse (MVP). Methods: The study population consisted of 58 consecutive patients (32 women; mean age 33+10 years, range 16 to 68) with MVP and 35 asymptomatic healthy subjects the control group (26 woman; mean age 38+11 years, range 16 to 58). All the subjects in the two groups underwent thyroid function tests. Results: Baseline demographic and clinical characteristics of two groups were similar. There was no significant difference in the serum levels of free triiodothyronine (fT3), free thyroxine (fT4) and thyroid stimulating hormone (TSH) between the two groups. Serum TSH concentrations were under the lower limit of normal in 2 patients (3%) in the MVP group, however, they were within the normal limits in all the patients with control group (p=0.272). Serum fT3 and fT4 levels were within the normal range in the all patients in the both groups. Conclusion: This finding suggests that there is no relationship between the MVP and hyperthyroidism. Large clinical trials are required to clarify this issue.
Abstract (Original Language): 
Amaç: Tiroid bezi ve kalbin embriyolojik olarak yakın bir ilişkisi vardır. Ontojenik gelişimde tiroid ve kalp birlikte göç ederler. Tiroid hastalıklarında meydana gelen kardiyovaküler fonksiyonlardaki değişikliklerin bu yakın ilişkiden dolayı kaynaklanabileceği düşünülmüştür. Kronik lenfositik tiroidit ve Graves hastalığınde MVP insidansının arttığı fakat toksik nodüler guatrda anlamlı değişiklik olmadığı gösterilmiştir. Bilgimize göre Türkiye'de, MVP'li hastalarda tiroid fonksiyonlarının değerlendirildiği bir çalışma bulunmamaktadır. Bu çalışmanın temel amacı, mitral valv prolapsuslu (MVP) hastalarda tiroid fonksiyon testlerinin değerlendirilmesidir. Metod: Çalışmaya, mitral valv prolapsuslu ardışık 58 hasta (32'si kadın; yaş ortalaması 33+10, dağılım 16-68) ve kontrol grubu olarak sağlıklı asemptomatik 35 vaka (26'sı kadın; yaş ortalaması 38+11, dağılım 16-58) alındı. Her iki gruptaki tüm olguların tiroid fonksiyon testlerine bakıldı. Bulgular: Grupların bazal demografik ve klinik özellikleri benzerdi. İki grubun serbest serum triiyodotironin (sT3), serbest tiroksin (sT4) ve tiroid stimulan hormon (TSH) düzeyleri arasında anlamlı fark yoktu. Serum TSH düzeyleri, MVP grubundaki iki (%3) hastada normal sınırın altında iken, kontrol grubundaki tüm olgularda normal idi (p=0.272). Her iki gruptaki tüm hastaların serum serbest T3 ve serbest T4 düzeyleri normal sınırlar arasında idi. Sonuç: Çalışmamızın bulguları, MVP ile hipertiroidizm arasında bir ilişki olmadığını düşündürtmektedir. Bu konunun aydınlatılmasında büyük klinik çalışmalara ihtiyaç vardır.
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