Assessment of Electrocardiographic Changes and Associated Factors Among Thyroid Dysfunction Patients Attending Jimma Medical Center, Southwest Ethiopia: A Cross-Sectional Study

Abstract

Background

Thyroid dysfunction (TD) is a metabolic manifestation related to either excessive or inadequate production of thyroid hormones. It has been widely proven to have comorbidities like cardiovascular disease. An electrocardiograph is a simple investigative instrument used to assess cardiac status to prevent complications in the later stages of the disease.

Objective

To assess electrocardiogram (ECG) changes and associated factors among TD patients.

Methods

An institution-based cross-sectional study was conducted among 273 TD patients attending Jimma Medical Center from October 11 to December 11, 2021. An ECG tool with 12 leads was used to assess the cardiac status, and a semi-structured questionnaire was used to assess sociodemographic, behavioral, and comorbidity variables. Bodyweight, height, waist circumference (WC), hip circumference (HC), and blood pressure variables were recorded, and body mass index (BMI) and waist-to-hip ratio (WHR) were calculated.

Results

Out of a total of 273 analyzed and interpreted ECG results by the cardiologists, 185 (67.8%) had ECG alterations. The most common types of ECG changes were arrhythmia 153 (56%), followed by myocardial infarction 74 (27.1%), ventricular hypertrophy [left 20 (7.3%) and right 15 (5.5%)], left atrial enlargement 3 (1%), axis deviation, and other abnormalities 24 (8.8%) and 18 (6.6%), respectively. The identified predictor variables for the ECG changes were the age group of 41 to 60 years old [AOR = 2.5, 95% CI: 1.25, 5.05], being female [AOR = 2.7, 95% CI: 1.28, 5.59], having diabetes mellitus [AOR = 4.25, 95% CI: 1.6, 11.2], and not starting the treatment [AOR = 8.6, 95% CI: 3.45, 21.6].

Conclusion

This study revealed that the prevalence of ECG changes was high among TD patients. The most common type of ECG change observed was arrhythmia followed by myocardial infarction. The age range of 41–60 years old, being female, having diabetes mellitus, and not starting the treatment were significantly associated with the ECG changes. Implementing an efficient noninvasive screening of cardiac status can detect unrecognized and asymptomatic cardiac impairment in TD patients.

Keywords:

• cardiovascular disease
• electrocardiogram
• Ethiopia
• thyroid dysfunction

Abbreviations

AOR, Adjusted Odds Ratio; BMI, Body Mass Index; BP, Blood Pressure; COR, Crude odds ratio; DM, Diabetes Mellitus; ECG, Electrocardiogram; TD, Thyroid Dysfunction; WHO, World Health Organization.

Data Sharing Statement

All data obtained are available in this manuscript. However, any reasonably required data will be available per the corresponding author on request.

Acknowledgments

First and foremost, we would like to thank Haramaya University and Jimma University Institute of Health, Department of Biomedical Sciences, for providing the opportunity to conduct this paper. We extend our appreciation to the data collectors’ nurses for their unlimited support from the start to the accomplishment of data collection, and to our families and friends for their technical and emotional support. Last, but not least, we would like to thank all the study participants who took part in this study.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in conceiving the idea, study design, and managing the overall progress of the study in the acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that there is no competing interests.