Assessment of atrial fibrillation and associated cardiovascular Disorders among adult hyperthyroidism patient at jimma university follow Up clinics from june 2016- august 2021 g.c

Abstract

Background: The extent of thyroid disorders in Africa remains unknown but the few available studies done in Ethiopia reported the prevalence of autoimmune thyroid disease to be 1.2%. A considerable proportion of hyperthyroidism patients develop specific cardiovascular complications including Atrial fibrillation, heart Failure, pulmonary hypertension, dilated cardiomyopathy as well as ventricular arrhythmias. The heart is particularly sensitive to the change in local T3 levels. Objective: to find the cardiovascular disorders and assessment of factors associated with development and persistence of Atrial Fibrillation among hyperthyroidism adult patients, who were on follow up at JUMC clinic during June 2016 and August 2021. Materials and Methods: A retrospective cohort study was done. Data was collected on Oct. 2021GC by a structured questionnaire which included history and physical examination and investigation records. Data analyzed using SPSS version 26. statistical significance taken at p -value less than 0.05. Ethical clearance obtained from JUMC ethical committee. Result- A total 163 hyperthyroidism patients were included after fulfilling the inclusion criteria for final analysis. The mean Age of patients and duration of symptom was 40.9 years (±11.653) and 12.72 months (±8.8) respectively. Majority of were female 150(92.0%) and most frequent cardiovascular manifestation was SOB in 80 (58.3%), palpitations in 70 (52.1%), and PND in 39 (29.4%) of participants. Resting HR SBP, and DBP at presentation were a mean value of 115.26b/Min (±13.89),116.55(±18.4) and 69.75 (±9.1) respectively. Underlying medical disease found in forty-four patients which includes hypertension 26(16%), cardiac disease in 19(11.7%), DM in three, COPD in two and post TB fibrosis in one patient. Hyperthyroidism related cardiovascular (CV) complications in newly diagnosed hyperthyroidism patients were found in 30.67% and significantly associated Factors were, AF (p < .001& AOR= 7.3), underlying cardiac disease (P value =002 & AOR=3.25), LA-size (P=.001& AOR=3.36) and baseline FT3 (p =.041& AOR=2.1). Baseline TSH <0.01miu/L was a significant related factor for Hyperthyroidism cardiovascular complication in non-AF patients with p value <.001 and with AOR=.014(CI=.001 - .129). Similarly, an independent and significant associated factors with AF±HF includes, HF, NYHA class 3 & 4 CHF at DX; p value= .001 and AOR=9.01, Baseline T3 >5PG/ml; with P value .0O2 and AOR= 32.1, Diastolic Dysfunction with p value =.019 (AOR=5.51, 95% CI=1.32-22.99), LA-size >3.8cm; P value .006 and AOR=8.83, T3 or T4 normalization <12mon p value .032 and AOR=.086 ,RHD &/or other VHD; p