Changes in cardiac function and structure in newly diagnosed Graves' disease. A conventional and 2D-speckle tracking echocardiography study.
Overproduction of thyroid hormones leads to structural as well as functional cardiac changes. Conventional echocardiography but also recently developed sophisticated two-dimensional echocardiography speckle (2D-STE) tracking allow elaborate evaluation of these changes. Our purpose was to investigate the effects of thyroid hormones overproduction on the heart in patients with Graves' disease and changes that occur after 6 months thyrostatic therapy. We conducted a prospective, case-control study of 6 months duration. Full echocardiographic assessment at diagnosis and after 6 months of thyrostatic therapy were performed in 44 patients with Graves' disease, aged 37.6 ± 9.1 years. Additionally, 43 euthyroid controls were studied for the same time period. Left ventricular end diastolic diameter (LVEDD) and left ventricular end systolic diameter (LVESD) were higher in the patient group while triscupid annular plane systolic excursion (TAPSE) was lower in the patient group. Moreover, left ventricular (LV) mass index and left atrium (LA) volume index were higher in the Graves' disease group. Diastolic impairment as assessed with conventional echocardiography including tissue Doppler was present in the patient group (E/A ratio 0.87 ± 0.10,). 2D-STE analysis, revealed an increase in the strain rate at the isovolumic relaxation time (SRIVRT, 0.310 ± 0.07 patients versus 0.298 ± 0.09 s-1controls). Improvement in diastolic and right systolic function as well as in left ventricular structural parameters was observed after restoration of euthyroidism (E/A ratio from 0.87 ± 0.10 versus 0.9 ± 0.08, p < 0.05). Patients with newly diagnosed Graves' showed an improvement in diastolic function, right systolic function and structural parameters after 6 months of thyrostatic treatment.
1st Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece.
K
K
Aroditis
Hypertension Excellence Center, 1st Department of Internal Medicine, AHEPA University Hospital, 1 St. Kyriakidi street, 54636, Thessaloniki, Greece. pikilidou@gmail.com.
M
http://orcid.org/0000-0002-9456-3175
M
Pikilidou
2nd Cardiology Department, Hippokrateio University Hospital, Thessaloniki, Greece.
E
E
Vourvouri
Hypertension Excellence Center, 1st Department of Internal Medicine, AHEPA University Hospital, 1 St. Kyriakidi street, 54636, Thessaloniki, Greece.
L
L
Hadjistavri
Hypertension Excellence Center, 1st Department of Internal Medicine, AHEPA University Hospital, 1 St. Kyriakidi street, 54636, Thessaloniki, Greece.
P
P
Zebekakis
Division of Clinical and Molecular Endocrinology, 1st Department of Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece.
J
J
Yovos
1st Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece.
G
G
Efthimiadis
1st Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece.
H
H
Karvounis
D000328:Adult; D013956:Antithyroid Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006111:Graves Disease / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020127:Recovery of Function; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000187:drug effects
D013956:Antithyroid Agents
Echocardiography; Graves’ disease; Tissue Doppler
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