Meena C L, Meena R D, Nawal Rajani, Meena V K, Bharti Anju, Meena L P
Department of General Medicine, SMS Medical college, Jaipur, India.
Acta Inform Med. 2012 Dec;20(4):218-20. doi: 10.5455/aim.2012.20.21-218-220.
Adverse cardiovascular effect of hypothyroidism has been identified in many studies. Early identification of patients with sub-clinical hypothyroidism may lead to early treatment and thereby favourable effect on cardiovascular morbidity and mortality.
To find out the association of sub clinical hypothyroidism and left ventricular dysfunction and also to find out relationship between systolic and diastolic dysfunction in these patients.
A total 30 cases of sub clinical hypothyroidism along with 15 age sex matched healthy control subjects were included in study. Serum TSH, T4, T3 hormone level was measured and those who were found to have sub-clinical hypothyroidism underwent for 2DEcho.
Significant reduction in peak early filling velocity (PE) (p<0.001) and early filling time velocity integral (Ei) (p<0.001). Ratio of early and late peak velocities (PE/PA) (p<0.001), ratio of time velocity integral of early and atrial filling (Ei/Ai) (p<0.001) and ratio of the early peak to average velocity (PE/M) (p<0.001) were also reduced. Mean EF was 54.9± 5.55 as compared to 55.7 ± 3.46 of control subjects with a T.value of 0.48 ,however there was significant diastolic dysfunction in case of hypothyroid patients (mean Ei/Ai = 1.35 ± 0.53) as compared to control group subjects (mean Ei/AI = 2.11 ± 0.26) with a T value of 5.22.
Sub-clinical hypothyroidism showed significant diastolic dysfunction in the absence of significant impairment of systolic function.
许多研究已证实甲状腺功能减退对心血管有不良影响。早期识别亚临床甲状腺功能减退患者可能会带来早期治疗，从而对心血管疾病的发病率和死亡率产生有利影响。
探讨亚临床甲状腺功能减退与左心室功能障碍之间的关联，并找出这些患者收缩功能障碍与舒张功能障碍之间的关系。
本研究共纳入30例亚临床甲状腺功能减退患者以及15例年龄和性别匹配的健康对照者。检测血清促甲状腺激素（TSH）、甲状腺素（T4）、三碘甲状腺原氨酸（T3）激素水平，对确诊为亚临床甲状腺功能减退的患者进行二维超声心动图（2DEcho）检查。
早期峰值充盈速度（PE）显著降低（p<0.001），早期充盈时间速度积分（Ei）显著降低（p<0.001）。早期与晚期峰值速度之比（PE/PA）（p<0.001）、早期与心房充盈时间速度积分之比（Ei/Ai）（p<0.001）以及早期峰值与平均速度之比（PE/M）（p<0.001）也均降低。亚临床甲状腺功能减退患者的平均射血分数（EF）为54.9±5.55，而对照组为55.7±3.46，T值为0.48，然而甲状腺功能减退患者存在明显的舒张功能障碍（平均Ei/Ai = 1.35±0.53），与对照组（平均Ei/AI = 2.11±0.26）相比，T值为5.22。
亚临床甲状腺功能减退在收缩功能无明显损害的情况下表现出明显的舒张功能障碍。
