Acute and chronic hypothyroidism are associated with similar left ventricular diastolic dysfunction relative to the euthyroid state: results of doppler echocardiographic comparisons.

Abstract

BACKGROUND:

How the duration of hypothyroidism affects left ventricular diastolic function is not well-characterized.

AIM:

We sought to compare left ventricular diastolic function in acutely vs chronically hypothyroid patients vs euthyroid controls, and within individuals while on vs off T4.

SUBJECTS AND METHODS:

We prospectively performed such comparisons measuring pulsed-wave and color M-mode Doppler echocardiographic variables: early or late mitral peak velocities (E wave or A wave, respectively), E wave/A wave ratio, E wave deceleration time, isovolumic relaxation time (IVRT), mitral flow propagation velocity (Vp), E wave/Vp ratio. Subjects comprised the acute HYPO group, 10 patients undergoing T4 withdrawal ≥ 6 months post-primary treatment for differentiated thyroid cancer (DTC); the chronic HYPO group, 23 treatment-naïve Hashimoto thyroiditis patients; and 21 healthy euthyroid controls. Subjects were adults aged ≤ 60 yr, predominantly female, with sinus rhythm; exclusion criteria were cardiovascular or thyroid disorder besides DTC (Hashimoto thyroiditis) in acute (chronic) HYPO patients or medication (besides thyroid hormone) affecting cardiac or thyroid function.

RESULTS:

Mean IVRT was significantly delayed and mean Vp, significantly slowed in both HYPO groups vs controls (p<0.0005), but did not differ between HYPO groups. These variables also were significantly impaired (p<0.05) within individuals when off vs on T4 (no.=8 acute, 10 chronic HYPO patients). Both HYPO groups had elevated mean E wave/Vp ratios vs controls, but the elevation reached significance (p<0.05) only in the larger chronic HYPO group.

CONCLUSIONS:

Left ventricular diastolic dysfunction is largely similar in acutely or chronically hypothyroid patients off T4 vs healthy controls or the same patients on T4.

• Authors: A Gauna, H Messuti, G Papadopulos, G Benchuga, F Viale, R J Marlowe, M C Silva Croome
• Journal: Journal of endocrinological investigation (J Endocrinol Invest) Vol. 34 Issue 9 Pg. e281-6 (Oct 2011) ISSN: 1720-8386 [Electronic] Italy
• PMID: 21597313 (Publication Type: Journal Article)

Chemical References

• Triiodothyronine
• Thyroxine

Topics

• Acute Disease
• Adult
• Chronic Disease
• Diastole (physiology)
• Echocardiography, Doppler (methods)
• Female
• Humans
• Hypothyroidism (blood, drug therapy, physiopathology)
• Middle Aged
• Prospective Studies
• Thyroxine (blood, therapeutic use)
• Triiodothyronine (blood)
• Ventricular Dysfunction, Left (physiopathology)