Particularities of systolic and diastolic function in patients with hypothyroidism

Objective: Given the increasing incidence of hypothyroidism, especially secondary to autoimmune thyroiditis in the general population and cardiac complications induced by hypothyroidism, we aimed to evaluate systolic, diastolic and global function in patients with hypothyroidism and identify some features depending on central or peripheral etiology.

Methods: We studied 82 patients with a mean age of 56.22 ± 10.99 years, divided into 2 groups: group A-41 (50%) patients with clinical hypothyroidism for at least six months (29 with peripheral hypothyroidism and 12 with central hypothyroidism) and lot B – control of 41 (50%) patients. In these, we noted demographic, paraclinical and echocardiographic parameters (E, A, E/A ratio, E/E ratio, TDE, TRIV, Tei index, the presence of fluid in the pericardium).

Results: Patients with hypothyroidism showed higher values of A-wave (0.67 ± 0.17 m/s vs. 0.59 ± 0.19 m/s; p = 0.042), E / E’m ratio (9.55 ± 3.03 vs. 7.33 ± 3.02; p= 0.001) and TRIV (115.83 ± 31.71ms vs. 97.27 ± 18.84; p= 0.002) and a reduced E/E’m ratio (1.25 ± 0.46 vs. 1.02 ± 0.32; p= 0.009) than the control group. Tei index of global cardiac function was affected in patients with hypothyroidism (p= 0.0002). Patients with peripheral hypothyroidism compared to those with central hypothyroidism had a higher E/E’m ratio (p= 0.035), while systolic function and other parameters of diastolic function (E/A ratio, TRIV) were identical. The presence of pericardial fluid in patients with hypothyroidism was not an additional factor in altering diastolic function.

Conclusions: Patients with clinical hypothyroidism develop diastolic dysfunction and impairment of overall cardiac function, necessary to be recognized for the prevention of cardiac complications, especially in patients with pre-existing cardiac pathology.

ISSN
ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
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CNCSIS B+
CODE: 379
CME Credits: 10 (Romanian College of Physicians)
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