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与亚临床甲状腺功能亢进相关的左心室心肌特征早期异常。

Early abnormalities of left ventricular myocardial characteristics associated with subclinical hyperthyroidism.

作者信息

Di Bello V, Aghini-Lombardi F, Monzani F, Talini E, Antonangeli L, Palagi C, Di Cori A, Caraccio N, Delle Donne M G, Dardano A, Pinchera A, Mariani M

机构信息

Cardiac Thoracic and Vascular Department, University of Pisa, 56124 Pisa, Italy.

出版信息

J Endocrinol Invest. 2007 Jul-Aug;30(7):564-71. doi: 10.1007/BF03346350.

Abstract

The aim of the present study was to analyze heart function in subclinical hyperthyroidism (sHT) in otherwise healthy subjects by new methods using intramyocardial ultrasonic techniques. Twenty-four newly diagnosed and untreated sHT patients (20 women, 4 men; mean age: 42+/-4 yr) and 24 sex- and age-matched healthy volunteers were studied. All subjects were submitted to conventional 2D color-Doppler echocardiography, pulsed wave tissue Doppler imaging (PWTDI) for the analysis of diastolic function, color Doppler myocardial imaging (CDMI) for the analysis of regional strain and strain rate (SR) expression of regional myocardial deformability, and to integrated backscatter (IBS) for the evaluation of intrinsic contractility and tissue characterization. Regional myocardial systolic strain findings were significantly higher in sHT patients when compared with controls (p<0.001). Considering diastolic SR, the early phase of diastolic SR was compromised in sHT subjects as compared with controls (p<0.001). Cyclic variation index (CVI), expression of intrinsic contractility, was significantly higher in sHT subjects in comparison with controls (p<0.0001). IBS values were comparable between the 2 study groups. In conclusion, the present study suggests that in patients with sHT early systolic hyperdeformability and hypercontractility are present, together with impairment of both active and passive phases of diastole. On the contrary, no left ventricular hypertrophy or other structural alterations are documented.

摘要

本研究的目的是通过使用心肌内超声技术的新方法,分析健康受试者亚临床甲状腺功能亢进症(sHT)中的心脏功能。研究了24例新诊断且未治疗的sHT患者(20名女性,4名男性;平均年龄:42±4岁)以及24名年龄和性别匹配的健康志愿者。所有受试者均接受了常规二维彩色多普勒超声心动图检查、用于分析舒张功能的脉冲波组织多普勒成像(PWTDI)、用于分析区域应变和区域心肌变形能力应变率(SR)表达的彩色多普勒心肌成像(CDMI),以及用于评估固有收缩性和组织特征的背向散射积分(IBS)。与对照组相比,sHT患者的区域心肌收缩期应变结果显著更高(p<0.001)。考虑舒张期SR,与对照组相比,sHT受试者舒张期SR的早期阶段受损(p<0.001)。与对照组相比,sHT受试者的固有收缩性表达——周期性变化指数(CVI)显著更高(p<0.0001)。两个研究组之间的IBS值相当。总之,本研究表明,sHT患者存在早期收缩期过度变形性和过度收缩性,同时舒张期的主动和被动阶段均受损。相反,未记录到左心室肥厚或其他结构改变。

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