Arslan Alev, Baş Veysel Nijat, Uytun Salih, Poyrazoğlu Hatice Gamze
Division of Pediatric Cardiology Başkent University Faculty of Medicine, Adana Dr. Turgut Noyan Medical and Research Center, Adana.
Divison of Pediatric Endocrinology, Department of Pediatrics, Kayseri Education and Research Hospital, Kayseri.
J Pediatr Endocrinol Metab. 2017 May 1;30(5):557-560. doi: 10.1515/jpem-2016-0393.
Impaired heart functions in newborns with hypothyroidism should be reversed by levothyroxine substitution therapy. The aim of the study was to investigate heart functions with congenital hypothroidism (CH) in newborns and changes after levothyroxine substitution therapy, measured with tissue Doppler echocardiography and conventional echocardiography.
The study included 30 neonates with CH and 34 healthy controls. Echocardiography were performed at baseline, 2nd week and 6th month of therapy.
Heart systolic function was normal. Mitral E velocities and mitral E/A ratios were significantly lower in patients at baseline. Tei indices were significantly higher in patients and a significant negative correlation was detected between free thyroxine levels and Tei indices.When early and late post-treatment echocardiography findings are compared, a non-significant difference was detected.
Neonates with CH may exhibit systolic and diastolic heart dysfunction, which can be reversed by early L-T4 substitution treatment. The Tei index index should be measured in addition to conventional echocardiography.
先天性甲状腺功能减退症新生儿的心脏功能受损，左旋甲状腺素替代疗法应能使其恢复。本研究的目的是通过组织多普勒超声心动图和传统超声心动图，研究先天性甲状腺功能减退症（CH）新生儿的心脏功能以及左旋甲状腺素替代治疗后的变化。
本研究纳入了30例CH新生儿和34例健康对照。在治疗的基线、第2周和第6个月进行超声心动图检查。
心脏收缩功能正常。患者基线时二尖瓣E峰速度和二尖瓣E/A比值显著降低。患者的Tei指数显著升高，且游离甲状腺素水平与Tei指数之间存在显著负相关。比较治疗后早期和晚期的超声心动图结果，未发现显著差异。
CH新生儿可能表现出收缩和舒张性心脏功能障碍，早期L-T4替代治疗可使其逆转。除传统超声心动图外，还应测量Tei指数。
