We report 4 adult patients with thyrotoxicosis accompanied by irreversible low-output heart failure. Each patient showed elevated plasma levels of thyroid hormone and prolonged low-output heart failure even after thyroid function returned to normal. Specimens of the right ventricular myocardium stained with anti-β myosin heavy-chain MAb showed a normal staining pattern with a predominance of the β-form. Our observations suggest that thyrotoxicosis may be one possible cause of irreversible cardiomyopathy.
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