Background: Subclinical hyperthyroidism is associated with cardiovascular morbidity. Recent advances in echocardiography imaging have allowed sophisticated evaluation of myocardial tissue properties. Objective: To investigate the myocardial effects of long-term exogenous subclinical hyperthyroidism using two-dimensional speckle tracking echocardiography imaging (2D-STE). Design: Prospective, single-blinded, placebo-controlled randomized trial of 6 months duration with two parallel groups. Patients and methods: Totally 25 patients with a history of differentiated thyroid carcinoma on longterm TSH-suppressive levothyroxine (L-T4) substitution were randomized to persistent TSH-suppressive L-T4 substitution (low-TSH group) or restoration of euthyroidism. Additionally 40 euthyroid controls were studied. Results (proposal): At baseline, the group of patients showed normal left ventricular (LV) systolic function but impaired diastolic function as assessed with conventional echocardiographic parameters. Importantly, 2D-STE analysis demonstrated the presence of subclinical LV systolic and diastolic dysfunction with impaired circumferential and longitudinal strain and strain rate at the isovolumic relaxation time. After restoration of euthyroidism, a significant improvement in LV systolic and diastolic function as assessed with 2D-STE strain was observed. Conclusion: Prolonged subclinical hyperthyroidism leads to systolic and diastolic dysfunction, which is reversible after restoration of euthyroidism. 2D-STE is a more sensitive technique to evaluate subtle changes in LV performance of these patients. ©2010 European Society of Endocrinology.

Abnormal cardiac contractility in long-term exogenous subclinical hyperthyroid patients as demonstrated by two-dimensional echocardiography speckle tracking imaging

Bertini M.;
2010

Abstract

Background: Subclinical hyperthyroidism is associated with cardiovascular morbidity. Recent advances in echocardiography imaging have allowed sophisticated evaluation of myocardial tissue properties. Objective: To investigate the myocardial effects of long-term exogenous subclinical hyperthyroidism using two-dimensional speckle tracking echocardiography imaging (2D-STE). Design: Prospective, single-blinded, placebo-controlled randomized trial of 6 months duration with two parallel groups. Patients and methods: Totally 25 patients with a history of differentiated thyroid carcinoma on longterm TSH-suppressive levothyroxine (L-T4) substitution were randomized to persistent TSH-suppressive L-T4 substitution (low-TSH group) or restoration of euthyroidism. Additionally 40 euthyroid controls were studied. Results (proposal): At baseline, the group of patients showed normal left ventricular (LV) systolic function but impaired diastolic function as assessed with conventional echocardiographic parameters. Importantly, 2D-STE analysis demonstrated the presence of subclinical LV systolic and diastolic dysfunction with impaired circumferential and longitudinal strain and strain rate at the isovolumic relaxation time. After restoration of euthyroidism, a significant improvement in LV systolic and diastolic function as assessed with 2D-STE strain was observed. Conclusion: Prolonged subclinical hyperthyroidism leads to systolic and diastolic dysfunction, which is reversible after restoration of euthyroidism. 2D-STE is a more sensitive technique to evaluate subtle changes in LV performance of these patients. ©2010 European Society of Endocrinology.
2010
Abdulrahman, R. M.; Delgado, V.; Ng, A. C. T.; Ewe, S. H.; Bertini, M.; Holman, E. R.; Hovens, G. C.; Pereira, A. M.; Romijn, J. A.; Bax, J. J.; Smit, J. W.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11392/2437365
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