Skip to main content
SpringerLink
Log in

Isovolumetric Relaxation Time (IVRT): An Effective Tool in Management of Subclinical Hypothyroidism

  • Original Article
  • Published:
Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Hypothyroidism is a common condition in which thyroid gland doesn’t produce sufficient thyroid hormone. Normal range of TSH is 0.4 to 4 mIU/L. Patients with TSH between 5 and 10 mIU/L, with normal T4 are diagnosed to have subclinical hypothyroidism. Decision to treat, particularly the subclinical hypothyroidism is tailored to individual patients. In our study, isovolumetric relaxation time (IVRT) was used to detect the diastolic function of cardia in hypothyroid patient, with the help of 2D echocardiogram. Normal duration of IVRT is 54 to 65 μs and in hypothyroidism it is expected to increase. To assess, whether IVRT is an effective tool in the management of subclinical hypothyroidism. 50 patients attending otorhinolaryngology OPD with TSH level of 5 to 10 mIU/L were selected for the study. All these were sent for 2D echocardiogram, for the measurement of IVRT. These 50 patients were divided into 2 groups. Group A—patients with TSH level 5 to 10 mIU/L and normal IVRT. Group B—patients with TSH level 5 to 10 mIU/L and prolonged IVRT. Patients in Group A were not given thyroxine, and after 3 months, they were reviewed with TSH level and IVRT duration. Patients in Group B were started with thyroxine, and after 3 months, they were reviewed with TSH level and IVRT duration. The basal and 3 months follow up values of TSH and IVRT was analysed on both the groups. The p value of group A was not significant, but p value group B was significant. IVRT as a measuring tool in sub clinical hypothyroidism will definitely bring a major change in the concepts of treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hollowell JG, Stachling NW, Flanders WD et al (2002) Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab 87:489

    Article  CAS  Google Scholar 

  2. Ross Douglas S (2013) Subclinical hypothyroidism. In: Braverman Lewis E, Cooper David S (eds) Werner & Ingbar’s the thyroid a fundamental and clinical text, 10th edn. Wolters Kluwer, Pune, pp 629–630

    Google Scholar 

  3. Surks MI, Boucai L (2010) Age- and race-based serum thyrotropin reference its. J Clin Endocrinol Metab 95:496–502

    Article  CAS  Google Scholar 

  4. Ross Douglas S (2013) Subclinical hypothyroidism. In: Braverman Lewis E, Cooper David S (eds) Werner & Ingbar’s the thyroid a fundamental and clinical text, 10th edn. Wolters Kluwer, India, pp 523–524

    Google Scholar 

  5. Klein I, Danzi S (2007) Thyroid disease and the heart. Circulation 116:1725

    Article  Google Scholar 

  6. Danzi S, Dubon P, Klein I (2005) Effect of serum triiodothyronine on regulation of cardiac gene expression: role of histone acetylation. Am J Physiol Heart Circ Physiol 289(1):1506

    Article  Google Scholar 

  7. Carr AN, Kranias EG (2002) Thyroid hormone regulation of calcium cycling proteins. Thyroid 12:453

    Article  CAS  Google Scholar 

  8. Ojamaa K, Kenessey A, Klein I (2000) Thyroid hormone regulation of phospholamban phosphorylation in the rat heart. Endocrinology 141:2139

    Article  CAS  Google Scholar 

  9. Biondi B, Klein I (2004) Hypothyroidism as a risk factor for hypothyroidism. Endocrine 24:1

    Article  CAS  Google Scholar 

  10. Virtanen VK, Saha HH, Groundstroem KW et al (2009) Thyroid hormone substitution therapy rapidly hormone initiated at its integrin receptor. Am J Physiol Endocrinol Metab 297:E1238

    Article  Google Scholar 

  11. AlAfify AA, Al-Sherbiny MS (2013) Role of tissue doppler echocardiography in the diagnosis of subclinical left and right ventricular dysfunction in patients with subclinical hypothyroidism. Res J Cardiol 6(1):1–9

    Article  Google Scholar 

  12. Jagdish A, Singh H, Batra A, Siwach SB, Kumar R, Gupta R (2009) An echogardiography study on the effect of levothyroxine therapy on cardiac function and structure in hypothyroidism. J Indian Acad Clin Med 10(1&2):27–31

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Emergency Medicine, SS Institute of Medical Science, Davangere, Karnataka, India

    Gaddada Devara Mutt Basavaraj Jyothi Prakash

  2. Department of ENT, JJM Medical College, Davangere, Karnataka, India

    Uttarkar Pandurangarao Santosh & Janarthanan Sridurga

Authors
  1. Gaddada Devara Mutt Basavaraj Jyothi Prakash
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Uttarkar Pandurangarao Santosh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Janarthanan Sridurga
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Uttarkar Pandurangarao Santosh.

Ethics declarations

Conflict of interest

None.

Ethical Standards

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jyothi Prakash, G.D.M.B., Santosh, U.P. & Sridurga, J. Isovolumetric Relaxation Time (IVRT): An Effective Tool in Management of Subclinical Hypothyroidism. Indian J Otolaryngol Head Neck Surg 71, 449–452 (2019). https://doi.org/10.1007/s12070-019-01615-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12070-019-01615-z

Keywords

Search

Navigation