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Graves病所致新诊断甲亢的年轻成人左心室功能及收缩均匀性的变化

Changes in left ventricular function and contractile homogeneity in young adults with newly diagnosed hyperthyroidism due to Graves' disease.

作者信息

Zhou Mi, Tan Jing, Liu Jun, Yin Li-Xue, Wang Si-Jia, Xie Ling, Guo Zhi-Yu, Zhang Wen-Jun

机构信息

Department of Ultrasound in Medicine, Sichuan Provincial People's Hospital Affiliate Wenjiang Hospital, Chengdu, Sichuan, China.

Department of Cardiovascular Ultrasound and Non-invasive Cardiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, Sichuan, China.

出版信息

J Clin Ultrasound. 2020 May;48(4):216-221. doi: 10.1002/jcu.22802. Epub 2019 Dec 13.

Abstract

PURPOSE

The aim of this study was to investigate myocardial dysfunction and mechanical abnormalities in young patients with Graves' disease before therapy, using two-dimensional speckle tracking echocardiography.

METHODS

We performed a comprehensive transthoracic echocardiographic examination, including segmental and global radial strain, and time-to-peak radial strain, in 47 young patients with hyperthyroidism and 34 healthy adults. The time-to-peak radial strain was corrected by RR interval. The variables derived from radial myocardial deformation by the six-basal, six-mid, and six-apical segmental model were compared to investigate the difference of the myocardial function between the two groups.

RESULTS

Early diastolic mitral inflow velocity, E/A ratio, early diastolic mitral annular velocity, and e'/a' ratio were lower in patients with Graves' disease than in controls. The left ventricular end-diastolic volume, left ventricular end-systolic volume, stroke volume, cardiac output, heart rate, late diastolic mitral inflow velocity, and late diastolic mitral annular velocity were slightly higher in patients than in controls. Radial strain, global radial strain, and corrected time-to-peak radial strain were lower in the patient group.

CONCLUSIONS

The decreased radial strain, global radial strain, and corrected time-to-peak radial strain in young patients with newly diagnosed hyperthyroidism due to Graves' disease could serve as an early sign of subclinical cardiac involvement.

摘要

目的

本研究旨在使用二维斑点追踪超声心动图,调查未经治疗的年轻格雷夫斯病患者的心肌功能障碍和机械异常情况。

方法

我们对47例年轻甲亢患者和34名健康成年人进行了全面的经胸超声心动图检查,包括节段性和整体径向应变以及径向应变达峰时间。径向应变达峰时间用RR间期进行校正。比较由六基底段、六中段和六心尖段模型得出的径向心肌变形变量,以研究两组之间心肌功能的差异。

结果

格雷夫斯病患者的舒张早期二尖瓣流入速度、E/A比值、舒张早期二尖瓣环速度和e'/a'比值均低于对照组。患者的左心室舒张末期容积、左心室收缩末期容积、每搏输出量、心输出量、心率、舒张晚期二尖瓣流入速度和舒张晚期二尖瓣环速度略高于对照组。患者组的径向应变、整体径向应变和校正后的径向应变达峰时间较低。

结论

新诊断为格雷夫斯病所致甲亢的年轻患者,其径向应变、整体径向应变和校正后的径向应变达峰时间降低,可作为亚临床心脏受累的早期迹象。

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