Chuyên ngành: Nội tiết - 62720145

Họ tên: Nguyễn Quang Bảy

Ngày bảo vệ: 17-07-2017

Hướng dẫn 1:GS.TS. Phạm Gia Khải

Hướng dẫn 2: PGS.TS. Nguyễn Khoa Diệu Vân

Tóm tắt tiếng việt:

Tóm tắt tiếng anh:

SUMMARY OF PH.D THESIS

Thesis title: “Research on factors related to atrial fibrillation in hyperthyroidism patients and evaluate treatment results”

Speciality: Endocrinology.           Code: 62.72.01.45

Ph.D Student: Nguyen Quang Bay

Academic Supervisors: 1. Prof Pham Gia Khai, MD, Ph.D

                                       2. A/Prof Nguyen Kho Dieu Van, MD, Ph.D

University: HaNoi Medical University

SUMMARY OF NEW FINDINGS OF Ph.D THESIS

   Our research was carried out from March 2010 to December 2013 on 114 newly diagnosed hyperthyroidism patients (57 with atrial fibrillation, and 57 with sinus rythm) at BachMai Hospital. The following conclusions were found:

1.      Clinical and laboratory characteristics of patients with hyperthyroid-induced atrial fibrillation (AF): The average age was 54.1 ± 11.2 (from 30 to 76); Women/men ratio was 1.48. Duration of hyperthyroidism and AF were 5.6 ± 10.9, and 2.6 ± 8.8 months, respectively. The average level of FT4 and TSH was 72.95 ± 27.93 pmol/l, and 0.0059 ± 0.0016 mU/ml, respectively. 35.1% of patients had heart failure. On echocardiography, 52.6% of patients had left atrial > 35 mm (36.87 ± 6.17 mm on average); 100% of patients had PH > 25 mmHg (43.98 ± 11.09 mmHg on average); 24.56% of patients has EF >70% and 5.26% of patients has EF < 50%; Besides, 84.2% of patients have valve regurgitation, and 10.5% of patients has mitral valve prolapse

2.   Factors realated to AF in hyperthyroidism patients: Hyperthyroidism patients with AF was 7.2 year older than hyperthyroidism patients with sinus rhythm ( p < 0.01); AF result in more heart failure, with larger left atrial, increased of PAP, and decreased EF. AF was associated with valve regurgitation and mitral valve prolapse. Althought AF was more prevalent in male patients, and patients with longer duration of hyperthyroidism, but no statistically significant. AF wasn’t associated with increasing heart rate.

3. Results of AF management in hyperthyroidism patients after 6 treatment months: 59.6% of patients had medical treatment and 40.4% of patients had I¹³¹ therapy. After 6 months, 33.3% of patients got euthyroidism or hypothyroidism.

-      Results: After 6 months, 57.9% of patients had spontaneously reversion to sinus rhythm, when majority of patients were hyperthyroidism. The mean interval between start of treatment and sinus rhythm restoration was 5.9 + 7.3 weeks, most were in the first 16 weeks. Hear rate was controlled to < 100 bpm after 2.5 weeks of treatment with antithyroid drug and beta blocker. One patient died but no patient had thromboembilism during study.

-         Significant predictors of AF reversion to sinus rhythm were duration of AF < 1 month, Pulmonary artery pressure ≤ 55 mmHg, left atrial size ≤ 40 mm and EF > 70% (OR = 14.9). 

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