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Evaluation of right and left ventricular function using pulsed-wave tissue Doppler echocardiography in patients with subclinical hypothyroidism

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Abstract

Previous studies showed that sub-clinical hypothyroidism (SH) was associated with cardiovascular disorders, such as endothe-lial dysfunction, atherosclerosis and myocardial dysfunction. Only one study investigated left ventricular (LV) function using pulsed tissue Doppler echocardiography (TDE) in patients with SH. However, no study has used this technique in the identification of right ventricular (RV) function in these patients. We aimed to investigate the effect of SH on RVand LV function using TDE technique. The present study included 36 newly diagnosed SH patients and 28 healthy controls. For each subjects, serum free T3 (FT3), free T4 (FT4), total T3 (TT3), total T4 (TT4), TSH, peroxidase antibody (TPOab) and thyroglobulin antibody (TGab) levels were measured, and standard echocardiography and TDE were performed. In patients with SH, TSH levels were significantly higher, and TPOab and TGab levels were significantly higher when compared to healthy controls. TDE showed that the patients had significantly lower early diastolic mitral and tricuspid annular velocity (Ea) and early/late (Ea/Aa) diastolic mitral and tricuspid annular velocity ratio (p<0.05, p<0.05and p<0.001, p<0.001, respectively), and significantly longer isovolumetric relaxation time (IRT) of left and right ventricles (p<0.001 and p<0.001, respectively). However, Aa, Sa, and isovolumetric contraction time (ICT) and ET (ejection time) of left and right ventricle did not significantly differ (p=ns for all). In addition, a negative correlation between TSH and TD-derived tricuspid Ea velocity and Ea/Aa ratio, and a positive correlation between TSH and IRT of right ventricle were observed. Our findings demonstrated that SH is associated with impaired RV diastolic function in addition to impaired LV diastolic function.

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References

  1. Klein I, Ojamaa K. Thyroid hormone and the cardiovascular system. N Engl J Med 2001, 344: 501–9.

    Article  PubMed  CAS  Google Scholar 

  2. Dillmann WH. Biochemical basis of thyroid hormone action in the heart. Am J Med 1990, 88: 626–32.

    Article  PubMed  CAS  Google Scholar 

  3. Beekman RE, Hardeveld C, Simonides WS. Effect of thyroid state on systolic free calcium in resting and electrically stimulated cardiac myocytes. Acta Endocrinol (Copenh) 1988, 969: 18–27.

    CAS  Google Scholar 

  4. Xing HL, Zou JN, Ma JM, et al. Changes in plasma concentration of atrial natriouretic peptide and renin in patients with hypothyroidism. Chin J Endocrinol Metab 1995, 11: 68.

    Google Scholar 

  5. Biondi B, Klein I. Hypothyroidism as a risk factor for cardiovascular disease. Endocrine 2004, 24: 1–3.

    Article  PubMed  CAS  Google Scholar 

  6. Cikim AS, Oflaz H, Ozbey N, et al. Evaluation of endothelial function in subclinical hypothyroidism and subclinical hyperthyroidism. Thyroid 2004, 14: 605–9.

    Article  PubMed  Google Scholar 

  7. Lekakis J, Papamicheal C, Alevizaki, M, et al. Flow mediated, endothelium-dependent vasodilation is impaired in subjects with hypothyroyroidism, borderline hypothyroidism, and high normal serum thyrothropin (TSH) values. Thyroid 1997, 7: 411–4.

    Article  PubMed  CAS  Google Scholar 

  8. Miura S, Litaka M, Suzuki S, et al. Decrease in serum levels of thyroid hormone in patients with coronary heart disease. Endocr J 1996, 43: 657–63.

    Article  PubMed  CAS  Google Scholar 

  9. Vanderpump MPI, Tunbridge WMG, French M, et al. The development of ischemic heart disease in relation to autoimmune thyroid disease in a 20-years follow-up study of an English community. Thyroid 1996, 6: 155–60.

    PubMed  CAS  Google Scholar 

  10. Foldes J, Istvanfy M, Halmagyi M, Varadi A, Gara A, Paratos O. Hypothyroidism and the heart. Examination of left ventricular function in subclinical hypothyroidism. Acta Med Hung 1987, 44: 337–47.

    PubMed  CAS  Google Scholar 

  11. Biondi B, Fazio S, Palmieri EA, et al. Left ventricular diastolic dysfunction in patients with subclinical hypothyroidism. J Clin Endocrinol Metab 1999, 84: 2064–7.

    Article  PubMed  CAS  Google Scholar 

  12. Sahn DJ, De Maris A, Kisslo J, Weyman A, for the Committee on M-mode Standardization of the American Society of Echocardiography. Recommendation regarding quantitation in M-mode echocardiographic measurements. Circulation 1978, 58: 1072–83.

    Article  PubMed  CAS  Google Scholar 

  13. Alam M, Wardell J, Andersson E, Samad BA, Nordlander R. Characteristics of mitral and tricuspid annular velocities determined by pulsed wave Dopplertissue imaging in healthy subjects. J Am Soc Echocardiogr 1999, 12: 618–28.

    Article  PubMed  CAS  Google Scholar 

  14. Meluzin J, Spinarova L, Bakala J, et al. Pulsed Dopplertissue imaging of the velocity of tricuspid annular systolic motion; a new, rapid, and non-invasive method of evaluating right ventricular systolic function. Eur Heart J 2001, 22: 340–8.

    Article  PubMed  CAS  Google Scholar 

  15. Derumeaux G, Ovize M, Loufoua J, et al. Dopplertissue imaging quantitates regional wall motion during myocardial ischemia and reperfusion. Circulation 1998, 97: 1970–7.

    Article  PubMed  CAS  Google Scholar 

  16. Severino S, Caso P, Galderisi M, et al. Use of pulsed Doppler tissue imaging to assess regional left ventricular diastolic dysfunction in hypertrophic cardiomyopathy. Am J Cardiol 1998, 82: 1394–8.

    Article  PubMed  CAS  Google Scholar 

  17. Gaasch WH, Le Winter MM. Physiology of left ventricular relaxation and filling. In: Gaasch WH, ed. Left ventricular diastolic dysfunction and heart failure. Malvern: Lea Febiger 1994, 3–125.

    Google Scholar 

  18. Alam M, Wardell J, Andersson E, et al. Right ventricular function in patients with first inferior myocardial infarction: assessment by tricuspid annular motion and tricuspid annular velocity. Am Heart J 2000, 139: 710–5.

    Article  PubMed  CAS  Google Scholar 

  19. Efthimiadis GK, Parharidis GE, Karvounis HI, Gemitzis KD, Styliadis IH, Louridas GE. Doppler Echocardiographic Evaluation of Right Ventricular Diastolic Function in Hypertrophic Cardiomyopathy. Eur J Echocardiography 2002, 3: 143–8.

    Article  CAS  Google Scholar 

  20. Yu CM, Sanderson JE, Chan S, Yeung L, Hung YT, Woo KS. Right ventricular diastolic dysfunction in heartfailure. Circulation 1996, 93: 1509–14.

    Article  PubMed  CAS  Google Scholar 

  21. Galderisi M, Vitale G, D’Errico A, et al. Usefulness of pulsed tissue Dopplerfor the assessment of left ventricular myocardial function in overt hypothyroidism. Ital Heart J 2004, 5: 257–64.

    PubMed  Google Scholar 

  22. Di Bello V, Monzani F, Giorgi D, et al. Ultrasonic myocardial textural analysis in subclinical hypothyroidism. J Am Soc Echocardiogr 2000, 13: 832–40.

    Article  PubMed  Google Scholar 

  23. Vitale G, Galderisi M, Lupoli GA, et al. Left Ventricular Myocardial Impairment in Subclinical Hypothyroidism Assessed by a New Ultrasound Tool: Pulsed Tissue Doppler. J Clin Endocrinol Metab 2002, 87: 4350–5.

    Article  PubMed  CAS  Google Scholar 

  24. Monzani F, Di Bello V, Caraccio N, et al. Effect of Levothy-roxine on Cardiac Function and Structure in Subclinical Hypothyroidism: A Double Blind, Placebo-Controlled Study. J Clin Endocrinol Metab 2001, 86: 1110–5.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiology, Inonu University, Malatya, Turkey

    F. Kosar, E. Topal & Y. Aksoy

  2. Department of Endocrinology, Inonu University, Malatya, Turkey

    I. Sahin MD

  3. Department of Internal Medicine, Inonu University, Malatya, Turkey

    N. Turan

  4. Department of Biochemistry, Inonu University, Malatya, Turkey

    C. Taskapan

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  1. F. Kosar
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  2. I. Sahin MD
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  3. N. Turan
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  4. E. Topal
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  5. Y. Aksoy
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  6. C. Taskapan
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Correspondence to I. Sahin MD.

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Kosar, F., Sahin, I., Turan, N. et al. Evaluation of right and left ventricular function using pulsed-wave tissue Doppler echocardiography in patients with subclinical hypothyroidism. J Endocrinol Invest 28, 704–710 (2005). https://doi.org/10.1007/BF03347553

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