Tseng K H, Walfish P G, Persaud J A, Gilbert B W
Department of Medicine, Mount Sinai Hospital, University of Toronto Medical School, Ontario, Canada.
J Clin Endocrinol Metab. 1989 Sep;69(3):633-8. doi: 10.1210/jcem-69-3-633.
Systolic time intervals (STI) were measured directly from concurrent aortic and mitral valve echocardiographic tracings in 127 subjects to assess their utility as an index of peripheral tissue thyroid functional status. The subjects were categorized according to clinical symptoms and the results of thyroid function tests into the following 7 study groups: normal subjects (n = 34), overt hyperthyroid subgroup I (n = 12), overt hyperthyroid subgroup II (n = 28), subclinical hyperthyroid (n = 15), subclinical hypothyroid (n = 22), overt hypothyroid subgroup II (n = 6), and overt hypothyroidism subgroup I (n = 10). Compared with normal subjects, overt hyperthyroid subgroup I patients had a significantly shortened mean isovolumetric contraction time (ICT), preejection period (PEP), and PEP/LVET (LVET = left ventricular ejection time; P less than or equal to 0.0005); the overt hypothyroid subgroup I patients also had significantly lengthened mean ICT (P less than or equal to 0.005), PEP, and PEP/LVET (P less than or equal to 0.0005). Compared with normal subjects, overt hyperthyroidism subgroup II patients also had a very significant shortening of ICT (P less than 0.0005) as well as a significantly shortened PEP and PEP/LVET (P less than or equal to 0.005), whereas subclinical hyperthyroid patients (with normal serum free T4 index and total T3, and suppressed TSH by immunoradiometric assay) also had ICT, PEP, and PEP/LVET STI values which were significantly shortened (P less than 0.05) values. Compared to normal subjects, the overt hypothyroid subgroup II patients (who were clinically asymptomatic with reduced serum free T4 index and elevated TSH) had a prolongation of ICT, PEP, and PEP/LVET (P less than or equal to 0.05), whereas the values in subclinical hypothyroid patients were similar to those in normal subjects. From these observations we conclude that in the absence of underlying heart disease, the echocardiographic method used is a rapid, reliable, and sensitive technique for determining STI and provides direct information on peripheral tissue thyroid functional status.
对127名受试者同步进行主动脉和二尖瓣超声心动图描记，直接测量收缩期时间间期（STI），以评估其作为外周组织甲状腺功能状态指标的效用。根据临床症状和甲状腺功能测试结果，将受试者分为以下7个研究组：正常受试者（n = 34）、显性甲亢亚组I（n = 12）、显性甲亢亚组II（n = 28）、亚临床甲亢（n = 15）、亚临床甲减（n = 22）、显性甲减亚组II（n = 6）和显性甲减亚组I（n = 10）。与正常受试者相比，显性甲亢亚组I患者的平均等容收缩时间（ICT）、射血前期（PEP）和PEP/LVET（LVET = 左心室射血时间；P≤0.0005）显著缩短；显性甲减亚组I患者的平均ICT（P≤0.005）、PEP和PEP/LVET也显著延长（P≤0.0005）。与正常受试者相比，显性甲亢亚组II患者的ICT也非常显著缩短（P＜0.0005），PEP和PEP/LVET也显著缩短（P≤0.005），而亚临床甲亢患者（血清游离T4指数和总T3正常，免疫放射分析显示促甲状腺激素被抑制）的ICT、PEP和PEP/LVET STI值也显著缩短（P＜0.05）。与正常受试者相比，显性甲减亚组II患者（临床无症状，血清游离T4指数降低，促甲状腺激素升高）的ICT、PEP和PEP/LVET延长（P≤0.05），而亚临床甲减患者的值与正常受试者相似。从这些观察结果我们得出结论，在无潜在心脏病的情况下，所采用的超声心动图方法是一种快速、可靠且敏感的测定STI的技术，并能提供外周组织甲状腺功能状态的直接信息。
