Title: Echocardiographic Evaluation of Cardiac Function in Hypothyroidism
Authors: Dr Prasanna Kumar Rathor, Dr Nirmal Kumar Mohanty, Dr Rohit Kumar, Dr Sarat Chandra Singh
DOI: https://dx.doi.org/10.18535/jmscr/v6i3.175
Abstract
Hypothyroidism is one of the most common hormonal disorders being associated with increased cardiovascular morbidity and mortality. Early detection of diastolic dysfunction of left ventricle by echocardiography helps in timely therapeutic intervention with thyroid hormone supplementation and amelioration of symptoms. The main objective of the present study was aimed at the cardiovascular involvement in hypothyroid patients. The present study was carried out in 64 patients of hypothyroidism who attended to the hospital between September 2013 and September 2014 including both outpatients and inpatients.
Echocardiography showed significant reduction in early diastolic filling (E) with augmented late diastolic filling (A) resulting in decreased E/A ratio suggesting significant diastolic dysfunction. Tissue Doppler imaging showed reduction in peak early diastolic velocity (E1) and raised peak late velocity (A1) with increased E/E1 ration which is again suggestive of diastolic dysfunction. LV diastolic dysfunction was impaired in patients with hypothyroidism. Doppler echocardiography might be considered a reliable method for its assessment & further management.
Keywords: Hypothyroidism, Cardiovascular changes, Echocardiography.
References
- I, Danzi S. Thyroid disease and the heart. Circulation. 2007,116(15):1725-1735
- Fiarresga J., Feliciano J., Fernandes R. Relationship between coronary disease and sub-clinical hypothyroidism: an angiographic study. Rev.Port.cardiol.2009: 28 (5):535-543
- Pearce E.N.,Yang Q.,Benjamin E.J. et al. Thyroid function and left ventricular structure and function in the Framingham Heart Study.Thyroid.2010:20(4);369-373
- Rodondi ,Aujesky D.,Vittinghoff E. et al . Subclinical hypothyroidism and the risk of coronary heart disease; A meta analysis. Am.J.Med.2006:119(7);541-551
- Bough EW,Crowley WF,Ridgway EC. Myocardial function in hypothyroidism; relation to disease severity and response to treatment. Arch Intern Med,(1978).138; 1476-1480.
- Sahn DJ, De Maris A,Kissolo J et al, for the committee on M-mode standardisation of the American Society of Echocardio-graphy. Recommendation regarding quantitation in M-mode Echocardiography measurements. Circulation 1978:58;1072-1083.
- L. Meena, R.D. Meena,Rajani Nawal, V.K. et al .Assessment of left ventricular diastolic dysfunction in subclinical hypothyroidism. Acta Inform Med.2012 December:20(4);218-220.
- TK Mishra, SN Routray,S Das et al . Left Ventricular dysfunction in patients with subclinical hypothyroidism and its reversibility after hormone therapy,JAPI 2005 NOV:53;943-946.
- Gonzale Z , Vilchez F, Castillo L et al. Cardiac manifestations of primary hypothyroidism. Determinant factors and treatment response. Rev Esp Cardiol.1998 Nov:51(11);893-900.
- AL-Farttoosi. Cardiovascular Manifestation of Primary Hypothyroidism. The Iraqi Post graduate Medical Journal.2010:9(2);113-119.
- Rawat B,Satyal A. An echocardiographic study of cardiac changes in hypothyroidism and the response to treatment.Kathmandu Univ Med J(KUMJ).2003 Jul-Sep:2(3);182-7.
- Varma R,Jain AK,Ghose T. Heart in hypothyroidism –An Echocardiographic study.J Assoc Physician India.1996 Jun:44 (6);390-2.
- Gulbanu Erkan,Aycan Fahre Ercan and Atiye Cengel. The evalution of diastolic dysfunction with Tissue Doppler Echocardiography in women with Subclinical Hypothyroidism and the Effect of L-Thyroxine Treatment on Diastolic Dysfunction.A Pilot Study. J Thyroid 2001:654-656.
- Fatma Alibaz oner, Selen Yurdkul, Ender Oner et al. Evaluation of ventricular functions using Tissue Doppler echocardi-ography in patients with sub clinical hypothyroidism. Turk Kardiyol Dern Ars – Arch Turk Soc Cardiol 2011:39;129-136 .