GSMPIcan predictearlycardiac dysfunction in elderly high-risk DTCpatients after TSH suppression treatment

Objectives: To investigate the relationship between cardiac dysfunction and duration of treatment after TSH suppression therapy in elderly high-risk DTC patients.

Methods: GSMPI data of elderly high-risk DTC patients with aged 60-64 years from September 2015 to September 2016 at the First Affiliated Hospital of Zhengzhou University were collected. Patients were arranged for GSMPI as a baseline one month after total thyroidectomy, subsequently 131-iodine treatment and TSH suppression treatment were performed. Patients were divided into 2 groups according to the duration of TSH suppression treatment. GSMPI were performed after the 12th month treatment for group A and 18 months after treatment for group B. Left ventricular systolic and diastolic function parameters, myocardial contraction, synchronization and myocardial perfusion were obtained.

Results: A total of 46 elderly high-risk DTC patients with 60-64 years old were enrolled (13 males and 33 females with an average age of 62.19±1.2 years). The peak filling rate of group A and group B decreased significantly with the increase of TSH suppression time, from 3.28±0.59 to 2.59±0.51 after treatment for 12 months (P=0.043), and decreased to 2.03 ± 0.47 (P = 0.017) for 18 months. The peak ejection rate and LVEF value of group B decreased significantly (P<0.05). The phase angle, phase standard deviation and entropy of group B increased significantly (P<0.05). The total score of resting perfusion and the total perfusion deficit of group B were gradually increased (P<0.05).

Conclusions: TSH suppression therapy can induce cardiac dysfunction in elderly high-risk DTC patients. Left ventricular diastolic function decreased at the earliest one year after TSH suppression treatment, and worsened with time. Peak filling rate can predict cardiac dysfunction early and provide a basis for individualized diagnosis and treatment and prognosis evaluation.[Keywords] Peak filling rate; TSH suppression therapy; Differentiated thyroid cancer; Gated SPECT myocardial perfusion imaging; Cardiac dysfunction