Shenoy M M, Goldman J M
Am J Med Sci. 1987 Jul;294(1):1-9. doi: 10.1097/00000441-198707000-00001.
The concept of hypothyroid heart disease remains controversial. Although hemodynamic abnormalities have been described, the presence of underlying abnormal cardiac structures has not been confirmed. The authors studied 20 hypothyroid patients using M-mode echocardiography before and after l-thyroxine therapy. Fifteen additional hypothyroid patients were studied using two-dimensional echocardiography to confirm the data of the first study. The findings were the same in both studies: during hypothyroidism, the interventricular septum is thickened, the ratio of septal thickness to left ventricular posterior wall thickening is increased, the right ventricular wall is thickened, regional wall motion of interventricular septum and right ventricular wall is decreased, and global function of the left ventricle is decreased. These findings are reversed with l-thyroxine therapy; they occur within 6 months of the development of hypothyroidism, but appear unrelated to elevated TSH levels. Whether the thickened interventricular septum and right ventricular wall represent true muscular hypertrophy requires further elucidation. Nevertheless, these data demonstrate the existence of a hypothyroid cardiomyopathy.
甲状腺功能减退性心脏病的概念仍存在争议。尽管已经描述了血流动力学异常，但潜在的心脏结构异常尚未得到证实。作者对20例甲状腺功能减退患者在左甲状腺素治疗前后进行了M型超声心动图检查。另外15例甲状腺功能减退患者采用二维超声心动图进行研究，以证实第一项研究的数据。两项研究结果相同：甲状腺功能减退期间，室间隔增厚，室间隔厚度与左心室后壁增厚的比值增加，右心室壁增厚，室间隔和右心室壁的局部壁运动减弱，左心室整体功能下降。这些发现经左甲状腺素治疗后逆转；它们在甲状腺功能减退发生后的6个月内出现，但似乎与促甲状腺激素水平升高无关。增厚的室间隔和右心室壁是否代表真正的心肌肥厚需要进一步阐明。然而，这些数据证明了甲状腺功能减退性心肌病的存在。
