title: Early textural and functional alterations of left ventricular myocardium in mild hypothyroidism.
abstract: 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.
authors.affiliation: Department of Endocrinology and Metabolism, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy. falombard@endoc.med.unipi.it
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Aghini-Lombardi
authors.forename: Aghini-Lombardi
authors.initials: AL
authors.lastname: Fabrizio
authors.forename: Vitantonio
authors.initials: V
authors.lastname: Di Bello
authors.forename: Di Bello
authors.initials: DB
authors.lastname: Vitantonio
authors.forename: Enrica
authors.initials: E
authors.lastname: Talini
authors.forename: Talini
authors.initials: T
authors.lastname: Enrica
authors.forename: Andrea
authors.initials: A
authors.lastname: Di Cori
authors.forename: Di Cori
authors.initials: DC
authors.lastname: Andrea
authors.forename: Fabio
authors.initials: F
authors.lastname: Monzani
authors.forename: Monzani
authors.initials: M
authors.lastname: Fabio
authors.forename: Lucia
authors.initials: L
authors.lastname: Antonangeli
authors.forename: Antonangeli
authors.initials: A
authors.lastname: Lucia
authors.forename: Caterina
authors.initials: C
authors.lastname: Palagi
authors.forename: Palagi
authors.initials: P
authors.lastname: Caterina
authors.forename: Nadia
authors.initials: N
authors.lastname: Caraccio
authors.forename: Caraccio
authors.initials: C
authors.lastname: Nadia
authors.forename: Maria
authors.initials: M
authors.lastname: Grazia Delle Donne
authors.forename: Delle Donne Maria
authors.initials: DD
authors.lastname: Grazia
authors.forename: Carmela
authors.initials: C
authors.lastname: Nardi
authors.forename: Nardi
authors.initials: N
authors.lastname: Carmela
authors.forename: Angela
authors.initials: A
authors.lastname: Dardano
authors.forename: Dardano
authors.initials: D
authors.lastname: Angela
authors.forename: Alberto
authors.initials: A
authors.lastname: Balbarini
authors.forename: Balbarini
authors.initials: B
authors.lastname: Alberto
authors.forename: Mario
authors.initials: M
authors.lastname: Mariani
authors.forename: Mariani
authors.initials: M
authors.lastname: Mario
authors.forename: Aldo
authors.initials: A
authors.lastname: Pinchera
authors.forename: Pinchera
authors.initials: P
authors.lastname: Aldo
mesh_terms: 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
chemical_list: D013963:Thyroid Hormones