Early textural and functional alterations of left ventricular myocardium in mild hypothyroidism.
The aim of the present study was to evaluate cardiac function and texture in patients with subclinical hypothyroidism (sHT) both by conventional and new ultrasonic intramyocardial tissue techniques. sHT was characterized by normal serum free tetraiodotironine and free triiodotironine levels and slightly increased serum TSH level. Twenty-four patients affected by sHT and 24 sex- and age-matched healthy volunteers were studied. All subjects were submitted to conventional two-dimensional (2D)-color Doppler echocardiography, pulsed wave tissue Doppler imaging (PWTDI) for the analysis of the diastolic function, color Doppler myocardial imaging (CDMI) for the analysis of regional strain and strain-rate and integrated backscatter (IBS) for the evaluation of intrinsic contractility and tissue characterization. The results of the present study were: (a) the detection in sHT subjects of a lower cyclic variation index (CVI) indicating an altered myocardial intrinsic contractility; (b) a higher ultrasonic myocardial reflectivity indicating an altered myocardial texture; (c) the detection of lower systolic strain and strain-rate indicating an alteration of myocardial regional deformability; (d) an initial impairment of left ventricular diastolic function indicated by a decrease of peak E mitral flow velocity and an increase of peak A mitral flow velocity. All parameters studied with conventional 2D-echo in sHT patients were comparable with controls, except for a mild alteration in diastolic function. A significant correlation among systo-diastolic modifications detected by CDMI and IBS and serum TSH levels were found. The CVI at septum, the PWDTI S-peak wave and the systolic strain at septum were inversely related to the serum TSH levels. In conclusion, the new intramyocardial ultrasonic techniques confirm and extend the previous knowledge on the effect of the sHT on the heart, allowing the detection of early ultrastructural and regional functional systolic and diastolic abnormalities.
Aghini-Lombardi
Fabrizio
F
Department of Endocrinology and Metabolism, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy. falombard@endoc.med.unipi.it
Fabrizio
Aghini-Lombardi
AL
Di Bello
Vitantonio
V
Vitantonio
Di Bello
DB
Talini
Enrica
E
Enrica
Talini
T
Di Cori
Andrea
A
Andrea
Di Cori
DC
Monzani
Fabio
F
Fabio
Monzani
M
Antonangeli
Lucia
L
Lucia
Antonangeli
A
Palagi
Caterina
C
Caterina
Palagi
P
Caraccio
Nadia
N
Nadia
Caraccio
C
Grazia Delle Donne
Maria
M
Grazia
Delle Donne Maria
DD
Nardi
Carmela
C
Carmela
Nardi
N
Dardano
Angela
A
Angela
Dardano
D
Balbarini
Alberto
A
Alberto
Balbarini
B
Mariani
Mario
M
Mario
Mariani
M
Pinchera
Aldo
A
Aldo
Pinchera
P
D000328:Adult; D001024:Aortic Valve Stenosis / Q000209:etiology / Q000503:physiopathology; D003720:Densitometry; D004452:Echocardiography; D005260:Female; D005355:Fibrosis / Q000473:pathology; D006339:Heart Rate / Q000502:physiology; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D007037:Hypothyroidism / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D009200:Myocardial Contraction / Q000502:physiology; D009206:Myocardium / Q000473:pathology*; D013963:Thyroid Hormones / Q000097:blood; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology
D013963:Thyroid Hormones