title: Acute and chronic hypothyroidism are associated with similar left ventricular diastolic dysfunction relative to the euthyroid state: results of doppler echocardiographic comparisons.
abstract: BACKGROUND
  How the duration of hypothyroidism affects left ventricular diastolic function is not well-characterized.
  
  
  OBJECTIVE
  We sought to compare left ventricular diastolic function in acutely vs chronically hypothyroid patients vs euthyroid controls, and within individuals while on vs off T4.
  
  
  METHODS
  We prospectively performed such comparisons measuring pulsed-wave and color M-mode Doppler echocardiographic variables: early or late mitral peak velocities (E wave or A wave, respectively), E wave/A wave ratio, E wave deceleration time, isovolumic relaxation time (IVRT), mitral flow propagation velocity (Vp), E wave/Vp ratio. Subjects comprised the acute HYPO group, 10 patients undergoing T4 withdrawal ≥ 6 months post-primary treatment for differentiated thyroid cancer (DTC); the chronic HYPO group, 23 treatment-naïve Hashimoto thyroiditis patients; and 21 healthy euthyroid controls. Subjects were adults aged ≤ 60 yr, predominantly female, with sinus rhythm; exclusion criteria were cardiovascular or thyroid disorder besides DTC (Hashimoto thyroiditis) in acute (chronic) HYPO patients or medication (besides thyroid hormone) affecting cardiac or thyroid function.
  
  
  RESULTS
  Mean IVRT was significantly delayed and mean Vp, significantly slowed in both HYPO groups vs controls (p<0.0005), but did not differ between HYPO groups. These variables also were significantly impaired (p<0.05) within individuals when off vs on T4 (no.=8 acute, 10 chronic HYPO patients). Both HYPO groups had elevated mean E wave/Vp ratios vs controls, but the elevation reached significance (p<0.05) only in the larger chronic HYPO group.
  
  
  CONCLUSIONS
  Left ventricular diastolic dysfunction is largely similar in acutely or chronically hypothyroid patients off T4 vs healthy controls or the same patients on T4.
authors: Division of Endocrinology, Ramos Mejía Hospital, 1405 Buenos Aires, Argentina. agauna@intramed.net
authors: A
authors: A
authors: Gauna
authors: H
authors: H
authors: Messuti
authors: G
authors: G
authors: Papadopulos
authors: G
authors: G
authors: Benchuga
authors: F
authors: F
authors: Viale
authors: R J
authors: RJ
authors: Marlowe
authors: M C
authors: MC
authors: Silva Croome
references: Ann Intern Med. 2002 Dec 3;137(11):904-14
references: 12458990
references: Am J Cardiol. 1995 Mar 15;75(8):645-8
references: 7887402
references: Angiology. 1992 Apr;43(4):287-93
references: 1558314
references: Circulation. 1993 May;87(5):1435-41
references: 8490997
references: J Am Coll Cardiol. 1996 Feb;27(2):365-71
references: 8557907
references: J Clin Endocrinol Metab. 1999 Jun;84(6):2064-7
references: 10372711
references: J Am Coll Cardiol. 2000 Feb;35(2):363-70
references: 10676682
references: Eur J Clin Invest. 2009 Mar;39(3):204-10
references: 19260950
references: Endocr Relat Cancer. 2004 Jun;11(2):345-56
references: 15163309
references: Eur J Endocrinol. 2007 Jan;156(1):13-9
references: 17218721
references: Thyroid. 2002 Jun;12(6):505-10
references: 12165114
references: N Engl J Med. 2001 Feb 15;344(7):501-9
references: 11172193
references: J Clin Endocrinol Metab. 2001 Mar;86(3):1110-5
references: 11238494
references: Clin Endocrinol (Oxf). 1994 Feb;40(2):227-33
references: 8137522
references: N Engl J Med. 1991 Nov 28;325(22):1557-64
references: 1834939
references: Endocr Rev. 2005 Aug;26(5):704-28
references: 15632316
references: Biomed Pharmacother. 2006 Sep;60(8):431-6
references: 16935462
references: Ital Heart J. 2004 Nov;5(11):857-63
references: 15633442
references: Eur J Endocrinol. 2006 Jul;155(1):3-9
references: 16793943