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Dyspnea on exertion is a common complaint in hyperthyroidism, and this thyroid dysfunction has been implicated as a primary cause of impaired effort tolerance. Using spirometry and spiroergometry, 42 patients with untreated hyperthyroidism were examined, and the condition was controlled 7 days later under propranolol monotherapy, as well as after 6 months in euthyroidism. While hyperthyroid, reduced forced vital capacity and tidal volume at the anaerobic threshold (AT) were observed in comparison to euthyroidism. Decreased oxygen (O2) pulse at AT (7 +/- 0.4 vs. 9.1 +/- 0.4 mL/beat, P = 0.0012) and at maximal exercise was noted in hyperthyroidism and was enhanced under propranolol (8.9 +/- 0.4 mL/beat, P = 0.0001). During exercise, the increment of minute ventilation (16.1 +/- 0.7 vs. 20.2 +/- 1.0 L/min, P = 0.0015), O2 uptake (9 +/- 0.5 vs. 11.4 +/- 0.5 mL/min/kg, P = 0.0022), O2 pulse (4.0 +/- 0.3 vs. 5.6 +/- 0.3 mL/beat, P = 0.0001), and heart rate (53 +/- 2 vs. 65 +/- 3 beat/min, P = 0.0004) was markedly lower in hyper- vs. euthyroidism. Work rate at AT and at maximum was reduced in hyper- vs. euthyroidism (107.4 +/- 3 vs. 141.1 +/- 4 watt, P = 0.0001). Negative correlations between free T3 and O2 pulse at AT (r = -0.59, P = 0.0005), delta O2 uptake (r = -0.54, P = 0.0007), delta minute ventilation (r = -0.48, P = 0.0007), and maximal work rate (r = -0.62, P = 0.0001) were noted. In hyperthyroidism, analysis of respiratory gas exchange showed low efficiency of cardiopulmonary function, respiratory muscle weakness, and impaired exercise capacity, which were reversible in euthyroidism.

Ineffective Cardiorespiratory Function in Hyperthyroidism1