Evaluation of Left Ventricular Function and Volumes at Maximum Workload in Patients with Euthyroid Goiter

Objective: The left ventricular ejection fraction (LVEF) is a critical predictor of coronary artery disease and cardiac mortality. This study aimed to evaluate changes in cardiac volume at rest and under stress conditions in patients with euthyroid goiter who were followed in a thyroid diseases outpatient clinic. Mateial and Methods: This retrospective study included 557 patients who underwent gated myocardial perfusion scintigraphy between 2016 and 2023. Of these, 378 patients (66%) were female, with a mean age of 57 years (range: 48–64). Pharmacological stress was administered to 123 (44%) of the 277 patients with euthyroid goiter, while treadmill exercise stress was applied to 154 (56%). In the control group of 280 patients, 125 (45%) underwent pharmacological stress, and 155 (55%) underwent treadmill exercise stress. Results: No significant difference was observed between the two groups regarding resting ejection fraction values. However, post-stress ejection fraction values were significantly lower in patients with euthyroid goiter compared to the control group. This difference was particularly pronounced in patients subjected to pharmacological stress using adenosine. Conclusion: While euthyroid goiter patients are typically monitored without treatment, the emergence of recurrent hypothyroid symptoms may indicate the need for thyroxine therapy. Even in the absence of hypothyroid symptoms at rest, these patients may exhibit atypical responses to certain medications and cardiac stress procedures. Clinicians should exercise caution regarding the potential for prolonged drug effects in this population.