title: Cardiac autonomic function and global left ventricular performance in autoimmune eauthyroid chronic thyroiditis: is treatment necessary at the euthyroid stage?
abstract: OBJECTIVE
  Autoimmune chronic thyroiditis (ACT) is characterized by lymphocyte infiltration in the thyroid gland and the presence of antithyroid antibodies in serum. Medical treatment does not affect antibody levels and treatment decision is not definite yet for the euthyroid patients. We aimed to evaluate cardiac autonomic function and global left ventricular performance in autoimmune euthyroid chronic thyroiditis and determine the need for medical treatment.
  
  
  METHODS
  We studied 30 ACT patients and 25 healthy control subjects. Cardiac autonomic function is evaluated by heart rate recovery (HRR). Global left ventricular performance is evaluated by two-dimensional echocardiography and pulsed-wave tissue Doppler echocardiography.
  
  
  RESULTS
  There was no difference between patients and controls with respect to clinical and biochemical parameters except hemoglobin (13.67 ± 1.25 g/dL, 14.51 ± 1.35 g/dL, p:0.047) and low density lipoprotein (120.71 ± 24.91 mg/dL, 100.55 ± 14.73 mg/dL, p: 0.003). Tei index was significantly higher in ACT group (0.521 ± 0.074, 0.434 ± 0.034, P < 0.0001). E'/A' was found to be significantly lower (1.234 ± 0.42, 1.750 ± 0.291, P < 0.0001) and E/E' was found to be higher than the controls (8.482 ± 0.449, 6.039 ± 0.209, P < 0.0001). HRR was significantly lower than the controls (20 ± 4 BPM, 30 ± 8 BPM, P < 0.0001).
  
  
  CONCLUSIONS
  Although left ventricular performance is found to be normal by conventional echocardiographic methods, it is found to be impaired when Tei index and tissue Doppler parameters are used. Cardiac autonomic function is also impaired in ACT patients. As a result of these cardiac changes, medical treatment may be considered earlier, even at the euthyroid stage.
authors.affiliation: Department of Cardiology, Ufuk University School of Medicine, Ankara, Turkey. eakgul2004@yahoo.com
authors.forename: Ebru
authors.initials: E
authors.lastname: Akgul
authors.forename: Utku
authors.initials: U
authors.lastname: Kutuk
authors.forename: Sibel
authors.initials: S
authors.lastname: Ertek
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cesur
authors.forename: Sengul
authors.initials: S
authors.lastname: Cehreli
authors.forename: Hasan Fehmi
authors.initials: HF
authors.lastname: Tore
authors.forename: Gurbuz
authors.initials: G
authors.lastname: Erdogan
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D018450:Disease Progression; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D008297:Male; D012307:Risk Factors; D013967:Thyroiditis, Autoimmune / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy