Cardiac function in borderline hypothyroidism: a study by pulsed wave tissue Doppler imaging

• Published in: European journal of endocrinology Vol. 152; no. 4; pp. 527 - 533
• Main Authors: Zoncu, Sandra, Pigliaru, Francesca, Putzu, Claudia, Pisano, Lorella, Vargiu, Sara, Deidda, Martino, Mariotti, Stefano, Mercuro, Giuseppe
• Format: Journal Article
• Language: English
• Published: Colchester European Society of Endocrinology 01.04.2005; Portland Press
• Subjects: Adult; Biological and medical sciences; Clinical Studies; Diastole; Echocardiography, Doppler, Pulsed; Endocrinopathies; Female; Fundamental and applied biological sciences. Psychology; Heart - physiopathology; Humans; Hypothyroidism - physiopathology; Male; Medical sciences; Middle Aged; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Systole; Thyroid Gland - physiopathology; Thyroid. Thyroid axis (diseases); Thyrotropin - blood; Thyroxine - blood; Triiodothyronine - blood; Vertebrates: endocrinology; Endocrinopathy; Sonography; Doppler ultrasound study; Cardiac performance; Borderline; Thyroid diseases; Medical imagery; Hypothyroidism; Endocrinology
• ISSN: 0804-4643; 1479-683X
• DOI: 10.1530/eje.1.01903

Objective: In subclinical hypothyroidism (SH), impaired diastolic function has been documented at rest and on effort, while systolic dysfunction has only been assessed on effort. Design: The aim of the present study was: (a) to further assess systolic function at rest in SH; and (b) to ascertain whether cardiac dysfunction could precede TSH increase in euthyroid patients with a high risk of developing SH. Methods: We studied 32 patients with classical Hashimoto’s thyroiditis (22 with increased serum TSH (> 3 mU/ml – group A), and 10 with normal serum TSH (< 3 mU/ml – group B)); a third group (C), which included 13 healthy controls. All subjects underwent pulsed wave tissue Doppler imaging (PWTDI) to accurately quantify the global and regional left ventricular function. Results: When compared with group C, PWTDI indices showed that in both groups A and B there was a significant impairment of systolic ejection (P < 0.001 and P < 0.05, respectively), a delay in diastolic relaxation (P < 0.001 and P < 0.05, respectively) and a decrease in the compliance to the ventricular filling (P < 0.05). Several significant correlations were found between PWTDI parameters and serum-free T3 and T4 and TSH concentrations. Conclusion: PWTDI is a sensitive technique that allows detection of both diastolic and systolic abnormalities, not only in patients with SH, but also in euthyroid subjects with a high risk of developing thyroid failure. Futhermore, the significant correlations of several PWTDI indices with serum FT3 and TSH concentrations strongly support the concept of a continuum spectrum of a slight thyroid failure in autoimmune thyroiditis extending to subjects with serum TSH still within the normal range.