title: Abnormal left ventricular longitudinal functional reserve assessed by exercise pulsed wave tissue Doppler imaging in patients with subclinical hypothyroidism.
abstract: BACKGROUND
  Response of systolic and diastolic velocities of mitral annulus to exercise in patients with subclinical hypothyroidism (SCH) has not been explored previously. We sought to investigate whether SCH is associated with abnormal left ventricular (LV) longitudinal function reserve to exercise.
  
  
  METHODS
  Mitral annular systolic (S') and early diastolic (E') velocities were measured at rest and during supine bicycle exercise using tissue Doppler echocardiography (TDE) in 23 patients with newly diagnosed SCH and 25 controls. LV diastolic and systolic longitudinal function reserve indices were calculated.
  
  
  RESULTS
  There were no significant differences in mitral inflow velocities at rest between groups except for LV end-diastolic dimension and LV end-systolic dimension, which were higher in the control group. E' and S' at rest were also similar between the groups. However, S' (9.8 +/- 1.5 vs. 11.3 +/- 1.5 cm/sec at 25 W, P = 0.001; and 11.3 +/- 1.8 vs. 13.1 +/- 1.8 cm/sec at 50 W, P = 0.001) and E' (13.8 +/- 1.4 vs. 15.7 +/- 1.6 cm/sec at 25 W, P < 0.001; and 15.6 +/- 1.6 vs. 18.2 +/- 1.5 cm/sec at 50 W, P < 0.001) during exercise were significantly lower in patients with SCH. Longitudinal systolic and diastolic function reserve indices were significantly lower in patients with SCH (systolic index, 1.4 +/- 0.9 vs. 2.5 +/- 0.9 cm/sec at 25 W, P = 0.001; and 2.7 +/- 1.3 vs. 4.1 +/- 1.2 cm/sec at 50 W, P = 0.001; diastolic index, 2.3 +/- 1.3 vs. 3.6 +/- 1.5 cm/sec at 25 W, P = 0.003; and 3.9 +/- 1.6 vs. 5.9 +/- 1.3 cm/sec at 50 W, P < 0.001).
  
  
  CONCLUSIONS
  Assessment of LV longitudinal functional reserve with exercise using TDE appears to be helpful in identifying early myocardial dysfunction in SCH.
authors.affiliation: Specialist Cevizli mahallesi, Keban sokak, Oba Apartmani, No: 5, Daire: 9 Kartal, Istanbul, Turkey. makcakoyun@yahoo.com
authors.forename: Mustafa
authors.initials: M
authors.lastname: Akcakoyun
authors.forename: Hasan
authors.initials: H
authors.lastname: Kaya
authors.forename: Ramazan
authors.initials: R
authors.lastname: Kargin
authors.forename: Selcuk
authors.initials: S
authors.lastname: Pala
authors.forename: Yunus
authors.initials: Y
authors.lastname: Emiroglu
authors.forename: Ozlem
authors.initials: O
authors.lastname: Esen
authors.forename: Hekim
authors.initials: H
authors.lastname: Karapinar
authors.forename: Zekeriya
authors.initials: Z
authors.lastname: Kaya
authors.forename: Ali Metin
authors.initials: AM
authors.lastname: Esen
mesh_terms: D000328:Adult; D003971:Diastole; D015150:Echocardiography, Doppler / Q000379:methods*; D005080:Exercise Test; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000503:physiopathology*; D008297:Male; D013599:Systole; D013972:Thyrotropin / Q000097:blood; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*; D016277:Ventricular Function, Left
chemical_list: D013972:Thyrotropin