Assessment of left ventricular diastolic function by radionuclide ventriculography at rest and exercise in subclinical hypothyroidism, and its response to L-thyroxine therapy.
Hypothyroidism is associated with intrinsic myocardial changes reflected by alterations in contractility and relaxation. Diastolic function, however, rather than systolic cardiac function, seems to be mostly impaired by thyroid hormone deprivation. Our aim was to evaluate diastolic function at rest and during maximal exercise by means of radionuclide ventriculography in subclinical hypothyroidism before and after restoration of euthyroidism. Ten subclinical hypothyroid patients (50 +/- 8.7 years) (thyroid-stimulating hormone 11 +/- 4.2 microUI/ml) without cardiac disease were studied before and 6 months after levothyroxine (L-T(4)) replacement (thyroid-stimulating hormone 1.9 +/- 1.1 microUI/ml). We compared the basal and post-therapy cardiac parameters with a control group of 14 euthyroid patients (52.5 +/- 10 years) (thyroid-stimulating hormone 2.5 +/- 1.2 microUI/ml). Multigated equilibrium radionuclide ventriculography was performed to assess systolic and diastolic ventricular function. Student's t and paired Student's t tests were applied for statistical analysis. We found a significant difference between the time to peak filling rate (TPFR) at rest before (0.241 +/- 0.002 ms) and after (0.190 +/- 0.012 ms) treatment with L-T(4). A significant difference that disappeared after restoration of euthyroidism was also observed between the basal TPFR values of the subclinical hypothyroid patients and the control group (0.189 +/- 0.01 ms). The same pattern was observed at maximal exercise. Thus, TPFR, a parameter of left ventricular (LV) diastolic function measured by radionuclide ventriculography, is impaired in subclinical hypothyroid patients both at rest and during exercise and returns to normal values after L-T(4) therapy.
Brenta
Gabriela
G
Departmtents of Endocrinology and Metabolism, French Hospital, Virrey del Pino 3370, 3oA Capital Federal, 1426 Buenos Aires, Argentina. brenta@cnea.gov.ar
Mutti
Luis Alberto
LA
Schnitman
Marta
M
Fretes
Osvaldo
O
Perrone
Alberto
A
Matute
María Luisa
ML
D001794:Blood Pressure / Q000502:physiology; D002784:Cholesterol / Q000097:blood; D003971:Diastole / Q000187:drug effects / Q000502:physiology; D004562:Electrocardiography; D015444:Exercise / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007037:Hypothyroidism / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010807:Physical Endurance / Q000502:physiology; D015635:Radionuclide Ventriculography / Q000379:methods; D012146:Rest / Q000502:physiology; D013974:Thyroxine / Q000627:therapeutic use*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology
D002784:Cholesterol; D013974:Thyroxine