THE INCIDENCE OF LEFT VENTRICULAR DIASTOLIC DYSFUNCTION IN PATIENTS AFFECTED WITH SUBCLINICAL HYPOTHYROIDISM
Keywords:Left ventricular diastolic dysfunction, Subclinical hypothyroidism, Cardiac dysfunction,, Diastolic, Echocardiographic evaluation
Numerous studies have identified the presence of adverse cardiovascular effects associated with hypothyroidism. The timely detection of individuals presenting with sub-clinical hypothyroidism has the potential to facilitate prompt intervention, consequently yielding a beneficial impact on cardiovascular morbidity and mortality rates.
The primary aim of this study is to investigate the potential correlation between subclinical hypothyroidism and left ventricular dysfunction. Additionally, we aim to explore the relationship between systolic and diastolic dysfunction in patients with subclinical hypothyroidism.
Materials and Methods:
In this study, a total of 60 cases of subclinical hypothyroidism, as well as 30 age- and sex-matched healthy control subjects, were included. Serum levels of thyroid-stimulating hormone (TSH), thyroxine (T4), and triiodothyronine (T3) were assessed, and individuals exhibiting subclinical hypothyroidism were subsequently subjected to a two-dimensional echocardiogram (2DEcho).
A statistically significant decrease was observed in peak early filling velocity (PE) (p<0.001) and early filling time velocity integral (Ei) (p<0.001). The statistical analysis revealed a significant reduction in the ratio of early and late peak velocities (PE/PA) (p<0.001), the ratio of time velocity integral of early and atrial filling (Ei/Ai) (p<0.001), and the ratio of the early peak to average velocity (PE/M) (p<0.001). The mean ejection fraction (EF) for the hypothyroid patients was 54.8 ± 5.54, which was slightly lower compared to the control subjects who had a mean EF of 55.6 ± 3.45.
In conclusion, the findings of this study indicate that sub-clinical hypothyroidism is associated with notable diastolic dysfunction, while systolic function remains largely unaffected.
TSH and T4 need to be repeated at least once after 2-3 months. TPO antibodies which indicate an autoimmune etiology of hypothyroidism should be measured.
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Copyright (c) 2023 Nirav Kumar, Chandra Bhanu Chandan, Ravi Vishnu Prasad, Gautam Kumar
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