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评价亚临床甲状腺功能减退症患者左心室收缩不同步的情况。

Evaluation of left ventricular systolic asynchrony in patients with subclinical hypothyroidism.

机构信息

Department of Cardiology, Faculty of Medicine, Abant Izzet Baysal University, Turkey.

出版信息

Cardiol J. 2012;19(4):374-80. doi: 10.5603/cj.2012.0068.

DOI:10.5603/cj.2012.0068
PMID:22825898
Abstract

BACKGROUND

The heart was very sensitive to fluctuating thyroid hormone levels. To assess intra-left ventricular (LV) systolic asynchrony in patients with subclinical thyroid dysfunction.

METHODS

Fifty patients with subclinical hypothyroidism and 40 controls were included. A diagnosis of subclinical hypothyroidism was reached with increased TSH and normal free T4. All subjects were evaluated by echocardiography. Evaluation of intra-LV systolic asynchrony was performed by tissue synchronization imaging (TSI), and four TSI parameters of systolic asynchrony were calculated. LV asynchrony was defined by these parameters.

RESULTS

All of the groups were similar in terms of demographic findings and conventional and Doppler echocardiograpic parameters except peak systolic velocity and early diastolic velocity. LV systolic asynchrony parameters of TSI including; standard deviation of Ts of the 12 LV segments (Ts-SD-12), maximal difference in Ts between any 2 of the 12 LV segments (Ts-12), standard deviation of TS of the 6 basal LV segments (Ts-SD-6), maximal difference in Ts between any of the 6 basal LV segments (Ts-6) were significantly lengthened in patients with subclinical hypothyroidism than controls (p <0.001, p < 0.001, p < 0.001 and p < 0.001, respectively). The prevalence of LV asynchrony was significantly higher in patients with subclinical hypothyroidism than control.

CONCLUSIONS

Patients with subclinical hypothyroidism present evidence of LV asynchrony by TSI. LV systolic asynchrony could be a warning sign of the early stage in cardiac systolic dysfunction in subclinical hypothyroid patients.

摘要

背景

心脏对甲状腺激素水平的波动非常敏感。评估亚临床甲状腺功能障碍患者的左室内(LV)收缩不同步。

方法

纳入 50 例亚临床甲状腺功能减退症患者和 40 例对照者。亚临床甲状腺功能减退症的诊断标准为 TSH 升高和游离 T4 正常。所有患者均行超声心动图检查。采用组织同步成像(TSI)评估 LV 收缩不同步,计算 4 个收缩不同步的 TSI 参数。LV 不同步通过这些参数定义。

结果

除了收缩期峰值速度和舒张早期速度外,各组的人口统计学发现和常规及多普勒超声心动图参数均相似。TSI 的 LV 收缩不同步参数包括:12 个 LV 节段 Ts 的标准差(Ts-SD-12)、12 个 LV 节段中任何两个节段之间 Ts 的最大差值(Ts-12)、6 个 LV 基底节段 Ts 的标准差(Ts-SD-6)和 6 个 LV 基底节段中任何一个节段之间 Ts 的最大差值(Ts-6)在亚临床甲状腺功能减退症患者中明显长于对照组(均 P<0.001)。亚临床甲状腺功能减退症患者的 LV 不同步发生率明显高于对照组。

结论

TSI 显示亚临床甲状腺功能减退症患者存在 LV 不同步。LV 收缩不同步可能是亚临床甲状腺功能减退症患者心脏收缩功能障碍早期的一个预警信号。

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