Abdelrazk Randa R, El-Sehrawy Amr A, Ghoniem Mohamed G M, Amer Maged Z
Internal Medicine Department.
Cardiology Department, Mansoura University Faculty of Medicine, Mansoura, Egypt.
Cardiovasc Endocrinol Metab. 2020 Dec 24;10(3):182-185. doi: 10.1097/XCE.0000000000000241. eCollection 2021 Sep.
Patients with subclinical hypothyroidism (SCH) are subjected to many cardiac changes. However, these changes are of gradual onset and cannot be usually detected using conventional diagnostic methods. Speckle tracking echocardiography (STE) is capable to detect cardiac function alterations usually unidentified by conventional echocardiography. The present study aimed to evaluate the role of STE in the detection of early cardiac changes in female patients with SCH.
The study included 33 female patients with SCH and 30 matched healthy volunteer women with normal thyroid functions who served as controls. Upon recruitment, all participants were subjected to careful history taking, thorough clinical examination and routine laboratory investigations, including thyroid-stimulating hormone and Free T4. The echocardiographic examination included conventional, color Doppler and two-dimensional STE.
Analysis of conventional echocardiographic data revealed that patients had significantly higher end-systolic volume when compared with controls. In addition, it was noted that SCH patients had significantly lower mitral E/A ratio, isovolumetric relaxation time and significantly higher left atrium volume index in comparison to controls. In respect to STE data, we noted that patients had significantly lower values of mid-anteroseptal, apical lateral, apical septal, apical apex, AP4L strain and global strain % when compared with controls.
Patients with SCH have deteriorated global strain in comparison to healthy controls.
亚临床甲状腺功能减退(SCH)患者会出现多种心脏变化。然而,这些变化是逐渐发生的,通常无法用传统诊断方法检测到。斑点追踪超声心动图(STE)能够检测出传统超声心动图通常无法识别的心脏功能改变。本研究旨在评估STE在检测SCH女性患者早期心脏变化中的作用。
该研究纳入了33例SCH女性患者和30例甲状腺功能正常的匹配健康志愿者女性作为对照。招募时,所有参与者均接受详细的病史采集、全面的临床检查和常规实验室检查,包括促甲状腺激素和游离T4。超声心动图检查包括传统、彩色多普勒和二维STE。
对传统超声心动图数据的分析显示,与对照组相比,患者的收缩末期容积显著更高。此外,还注意到,与对照组相比,SCH患者的二尖瓣E/A比值、等容舒张时间显著更低,左心房容积指数显著更高。关于STE数据,我们注意到,与对照组相比,患者的前间隔中部、心尖外侧、心尖间隔、心尖、AP4L应变和整体应变%值显著更低。
与健康对照组相比,SCH患者的整体应变有所恶化。