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Left ventricular functions in children with newly diagnosed Graves’ disease. A single-center study from Upper Egypt

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Abstract

This study aimed to evaluate the left ventricular (LV) functions in a cohort of children with Graves’ disease (GD). This is a cross-sectional case-control study. It included 36 children with GD and 36 healthy children matched for age and gender. Thyroid hormones (TSH, FT4, and FT3) and anti-thyroid autoantibodies [anti-thyroid peroxidase (anti-TPO), thyrotropin receptor (TRAbs), and thyroglobulin antibodies] were measured. Conventional and tissue Doppler imaging (TDI) echocardiographies were used to assess left ventricular systolic and diastolic functions. LV mass index (LVMI) and myocardial performance index (MPI) were also measured. Compared to healthy children, conventional echocardiography of patients with GD revealed higher LVMI (P = 0.001) indicating LV hypertrophy but normal LV functions while TDI revealed lower Em/Am ratio indicating LV diastolic dysfunction (P = 0.001). Significant correlations were reported between FT4 with LVMI (P = 0.05), Em/Am (P = 0.01), and MPI (P = 0.01). In multivariate analysis, a positive correlation was identified between FT4 with MPI (OR = 1.17; 95% CI = 1.09–1.15; P = 0.001).

Conclusions: Children with newly diagnosed GD may have significant subclinical changes in LV structure and function (diastolic and global). TDI is more sensitive than conventional Doppler in detecting LV dysfunction. These findings highlight the importance of early monitoring of children with GD for left ventricular mass index and diastolic function.

What is Known:

• There is an increased risk for cardiac abnormalities in children with Graves’ disease (GD).

• Limited studies assessed left ventricular function in patients with GD.

What is New:

• Children with newly diagnosed GD may have significant subclinical changes in left ventricular structure and functions.

• Children with newly diagnosed GD should be monitored for left ventricular mass index and diastolic function.

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Abbreviations

BMI:

Body mass index

GD:

Grave’s disease

LVMI:

Left ventricular mass index

MPI:

Myocardial performance index

TDI:

Tissue Doppler imaging

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Author information

Authors and Affiliations

  1. Department of Pediatrics, Pediatric Endocrinology Unit, Faculty of Medicine, Assiut University, Assiut, B.O 71111, Egypt

    Kotb Abbass Metwalley & Hekma Saad Farghaly

  2. Department of Clinical Pathology, Qena Faculty of Medicine, South Valley University, Qena, Egypt

    Abdelrahman Abdelhamid

Authors
  1. Kotb Abbass Metwalley
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  2. Hekma Saad Farghaly
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  3. Abdelrahman Abdelhamid
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Contributions

KA participated in the design of the protocol of the study, coordination of the research, performance of the clinical part, analyses of the data, and writing the draft of the paper. HS participated in the design of the protocol of the study, performed the echocardiography, and participated in the analyses of the data and writing the draft of the paper. AA performed the laboratory investigations and participated in the analyses of the results. All the authors read and approved the manuscript.

Corresponding author

Correspondence to Kotb Abbass Metwalley.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

The study protocol was approved by the Ethics Committee of Faculty of Medicine, Assiut Children University Hospital, Assiut, Egypt.

Informed consent

Written informed consents were obtained from the parents of all participants.

Additional information

Communicated by Peter de Winter

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Cite this article

Metwalley, K.A., Farghaly, H.S. & Abdelhamid, A. Left ventricular functions in children with newly diagnosed Graves’ disease. A single-center study from Upper Egypt. Eur J Pediatr 177, 101–106 (2018). https://doi.org/10.1007/s00431-017-3039-0

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  • DOI: https://doi.org/10.1007/s00431-017-3039-0

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