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Prospective echocardiographic evaluation of patients with endogenous subclinical hyperthyroidism and after restoring euthyroidism
Author(s) -
Kaminski Grzegorz,
Michalkiewicz Dariusz,
Makowski Karol,
Podgajny Zbigniew,
Szalus Norbert,
Ruchala Marek,
Szczepanek Ewelina,
Gielerak Grzegorz
Publication year - 2011
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.2010.03957.x
Subject(s) - medicine , ventricle , cardiology , isovolumetric contraction , subclinical infection , contractility , diastole , endocrinology , blood pressure
Summary Objectives Clinical significance of, and the need for, treatment in subclinical hyperthyroidism (sHT) is still a matter of debate. The aim of the study was to assess the impact of sHT on echocardiographic parameters. Design Patients with endogenous sHT of nonautoimmune origin underwent full echocardiographic assessment at diagnosis and after restoring euthyroidism with radioiodine treatment. Patients Studied group consisted of 44 patients (37 women, 7 men), aged 22–65 years (mean 45·9 ± 11·0). Measurements Full echocardiographic assessment included estimation of cardiac chamber diameters and volume as well as cardiac contractility, according to the guidelines of the American Society of Echocardiography. Left ventricular mass was calculated according to Penn’s convention. For estimation of left ventricle diastolic function, the following echocardiographic parameters were obtained: maximal early filling wave velocity (E), maximal late filling wave velocity (A), E/A ratio, isovolumetric relaxation time and early filling wave deceleration time. Results In the studied group, phase of sHT was associated with increased volume of heart chambers, increased diameter of ascending aorta, increased left ventricle mass and disturbed left ventricle relaxation ( P < 0·05). The systolic function of the left ventricle was unaffected; however, the ejection time was shortened. The changes were reversible with restoring biochemical euthyroidism ( P < 0·05). Moreover, a significant correlation between some of the parameters and thyroid hormones concentration was demonstrated. Conclusions sHT was associated with significant changes in echocardiographic parameters, which may contribute to increased cardiovascular risk in these patients. The alterations were reversible with restoring biochemical euthyroidism, what supports the necessity of treatment introduction in sHT.