TY - JOUR
T1 - Heart rate variability in hypothyroid patients
T2 - a systematic review and meta-analysis
AU - Brusseau, Valentin
AU - Tauveron, Igor
AU - Bagheri, Reza
AU - Ugbolue, Ukadike Chris
AU - Magnon, Valentin
AU - Navel, Valentin
AU - Bouillon-Minois, Jean Baptiste
AU - Dutheil, Frederic
PY - 2022/6/3
Y1 - 2022/6/3
N2 - Introduction Hypothyroidism may be associated with changes in the autonomic regulation of the cardiovascular system, which may have clinical implications.Objective To conduct a systematic review and meta-analysis on the impact of hypothyroidism on HRV.Materials and methods PubMed, Cochrane, Embase and Google Scholar were searched until 20 August 2021 for articles reporting HRV parameters in untreated hypothyroidism and healthy controls. Random-effects meta-analysis were stratified by degree of hypothyroidism for each HRV parameters: RR intervals (or normal to normal-NN intervals), SDNN (standard deviation of RR intervals), RMSSD (square root of the mean difference of successive RR intervals), pNN50 (percentage of RR intervals with >50ms variation), total power (TP), LFnu (low-frequency normalized unit), HFnu (high-frequency), VLF (very low frequency), and LF/HF ratio.Results We included 17 studies with 11438 patients: 1163 hypothyroid patients and 10275 healthy controls. There was a decrease in SDNN (effect size = -1.27, 95% CI -1.72 to -0.83), RMSSD (-1.66, -2.32 to -1.00), pNN50 (-1.41, -1.98 to -0.84), TP (-1.55, -2.1 to -1.00), HFnu (-1.21, -1.78 to -0.63) with an increase in LFnu (1.14, 0.63 to 1.66) and LF/HF ratio (1.26, 0.71 to 1.81) (p <0.001). HRV alteration increased with severity of hypothyroidism.Conclusions Hypothyroidism is associated with a decreased HRV, that may be explained by molecular mechanisms involving catecholamines and by the effect of TSH on HRV. The increased sympathetic and decreased parasympathetic activity may have clinical implications.
AB - Introduction Hypothyroidism may be associated with changes in the autonomic regulation of the cardiovascular system, which may have clinical implications.Objective To conduct a systematic review and meta-analysis on the impact of hypothyroidism on HRV.Materials and methods PubMed, Cochrane, Embase and Google Scholar were searched until 20 August 2021 for articles reporting HRV parameters in untreated hypothyroidism and healthy controls. Random-effects meta-analysis were stratified by degree of hypothyroidism for each HRV parameters: RR intervals (or normal to normal-NN intervals), SDNN (standard deviation of RR intervals), RMSSD (square root of the mean difference of successive RR intervals), pNN50 (percentage of RR intervals with >50ms variation), total power (TP), LFnu (low-frequency normalized unit), HFnu (high-frequency), VLF (very low frequency), and LF/HF ratio.Results We included 17 studies with 11438 patients: 1163 hypothyroid patients and 10275 healthy controls. There was a decrease in SDNN (effect size = -1.27, 95% CI -1.72 to -0.83), RMSSD (-1.66, -2.32 to -1.00), pNN50 (-1.41, -1.98 to -0.84), TP (-1.55, -2.1 to -1.00), HFnu (-1.21, -1.78 to -0.63) with an increase in LFnu (1.14, 0.63 to 1.66) and LF/HF ratio (1.26, 0.71 to 1.81) (p <0.001). HRV alteration increased with severity of hypothyroidism.Conclusions Hypothyroidism is associated with a decreased HRV, that may be explained by molecular mechanisms involving catecholamines and by the effect of TSH on HRV. The increased sympathetic and decreased parasympathetic activity may have clinical implications.
UR - http://www.scopus.com/inward/record.url?scp=85131701517&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0269277
DO - 10.1371/journal.pone.0269277
M3 - Review article
C2 - 35657799
AN - SCOPUS:85131701517
SN - 1932-6203
VL - 17
JO - PLoS ONE
JF - PLoS ONE
IS - 6
M1 - e0269277
ER -