Cardiomyopathy associated with Graves' disease

Clin Endocrinol (Oxf). 1996 Jul;45(1):111-6.


Cardiovascular changes associated with Graves' disease are generally considered to be secondary to the increased levels of thyroid hormone. We describe a case of Graves' disease in a 25-year-old man, who developed cardiomyopathy with severe heart failure. Pathological examination of the myocardial biopsies showed fibroblast infiltration and degenerative changes. After the cardiomyopathy subsided the patient developed a goitre and signs of hyperthyroidism, followed by Graves' ophthalmopathy, which was treated successfully with a combination of high-dose corticosteroids and orbital radiotherapy. These findings suggested a common pathogenesis for the cardiomyopathy and ophthalmopathy, and prompted us to investigate the expression of TSH receptor (TSH-R) in human heart. TSH-R mRNA was identified in human heart using the reverse transcriptasepolymerase chain reaction (RT-PCR) and DNA sequencing. Taken together, these data suggest that autoimmunity against the TSH-R might contribute to both the cardiomyopathy and ophthalmopathy in similar cases of Graves' disease.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Base Sequence
  • Cardiomyopathies / etiology*
  • Cardiomyopathies / metabolism
  • DNA Primers / genetics
  • Graves Disease / complications*
  • Graves Disease / metabolism
  • Humans
  • Male
  • Molecular Sequence Data
  • Myocardium / metabolism
  • Polymerase Chain Reaction
  • RNA, Messenger / analysis
  • Receptors, Thyrotropin / genetics
  • Receptors, Thyrotropin / metabolism*
  • Sequence Analysis, DNA


  • DNA Primers
  • RNA, Messenger
  • Receptors, Thyrotropin