title: Relationship between left ventricular mechanics and low free triiodothyronine levels after myocardial infarction: a prospective study.
abstract: Low free triiodothyronine (fT3) levels following acute myocardial infarction (AMI) are associated with greater impairment in cardiac mechanics compared with patients with AMI who have normal values of thyroid hormones. The objectives are to investigate left ventricular (LV) function and mechanics during a 6-month follow-up after myocardial infarction and to evaluate their prognostic implication using two-dimensional (2D) echocardiography and 2D speckle-tracking echocardiography in patients with low fT3 levels. The study design is prospective cohort study. One hundred forty patients with first-onset AMI were grouped according to serum fT3 levels: low fT3 group (fT3 <3.2 pmol/L; n = 44) and control group (fT3 >3.2 pmol/L; n = 96). Low levels of fT3 were associated with greater LV diameters and LV end-diastolic volume, and decreased systolic LV function. Systolic apical and basal rotation, peak systolic global longitudinal strain and strain rate, and LV twist and torsion were significantly decreased in the low fT3 group. The prognostic implication for predicting low fT3 levels was evaluated using ROC analysis. LV end-diastolic diameter index is the most sensitive (94.12 %), but has low specificity (37.93 %; area = 0.659, p = 0.01). By contrast, LV end-systolic volume is the most specific (94.03 %), but has low sensitivity (26.32 %; area = 0.594, p = 0.04). Low fT3 levels are significantly associated with worse LV mechanics. Low fT3 levels are important for prediction of LV structure, function, rotation, and deformation parameters during the late post-myocardial infarction period.
authors.affiliation: Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Eivenių 2, Kaunas, Lithuania. editajank1@gmail.com.
authors.forename: Edita
authors.initials: E
authors.lastname: Jankauskienė
authors.affiliation: Medical Academy, Lithuanian University of Health Sciences, Mickevičiaus 9, Kaunas, Lithuania.
authors.forename: Paulius
authors.initials: P
authors.lastname: Orda
authors.affiliation: Medical Academy, Lithuanian University of Health Sciences, Mickevičiaus 9, Kaunas, Lithuania.
authors.forename: Greta
authors.initials: G
authors.lastname: Barauskienė
authors.affiliation: Behavioral Medicine Institute, Lithuanian University of Health Sciences, Vydūno 4, Palanga, Lithuania.
authors.forename: Narseta
authors.initials: N
authors.lastname: Mickuvienė
authors.affiliation: Behavioral Medicine Institute, Lithuanian University of Health Sciences, Vydūno 4, Palanga, Lithuania.
authors.forename: Julija
authors.initials: J
authors.lastname: Brožaitienė
authors.affiliation: Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Eivenių 2, Kaunas, Lithuania.
authors.forename: Jolanta Justina
authors.initials: JJ
authors.lastname: Vaškelytė
authors.affiliation: Behavioral Medicine Institute, Lithuanian University of Health Sciences, Vydūno 4, Palanga, Lithuania.
authors.forename: Robertas
authors.initials: R
authors.lastname: Bunevičius
mesh_terms: D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D004452:Echocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D011446:Prospective Studies; D012372:ROC Curve; D000072657:ST Elevation Myocardial Infarction / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D014284:Triiodothyronine / Q000097:blood*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology; D020257:Ventricular Remodeling / Q000502:physiology*
chemical_list: D015415:Biomarkers; D014284:Triiodothyronine
keywords: Acute myocardial infarction; Left ventricular remodeling; Low-fT3 level; Speckle-tracking echocardiography