Cardiovascular Research Center, Kerman University of Medical Sciences, Kerman, Iran.
Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Iran J Med Sci. 2023 May;48(3):313-320. doi: 10.30476/IJMS.2022.92556.2389.
Since hyperthyroidism could be associated with right ventricular dysfunction, this study intended to investigate right ventricular (RV) function using strain echocardiography in hyperthyroid patients both at rest and in maximum-stress conditions.
This cross-sectional study was conducted at Rajaie Cardiovascular Medical and Research Center, Tehran, Iran, from January 2019 to January 2020. All study participants completed a maximum treadmill exercise test, as well as a complete two-dimensional echocardiogram at rest and the peak of stress test. The data were analyzed using SPSS statistical software. The independent samples test and Mann-Whitney U test were used for numerical, and the Chi square test was used for nominal variables. P<0.05 was considered statistically significant.
The final analysis included 52 participants (26 subjects in each group). In a maximal stress situation, we found that among the RV function indices, RV global longitudinal strain (P=0.0001), systolic strain rate (P=0.0001), diastolic strain rate (P=0.0002), and tricuspid annular plane systolic excursion (P=0.019) were reduced significantly in the hyperthyroid patients compared to the control group. There was also a linear correlation between RV size and thyroid stimulating hormone (TSH) level (P=0.009, r=0.36). Moreover, we found a negative linear correlation between TSH level with maximum stress RV strain and diastolic strain rate (P<0.001).
The findings of the present study revealed a significant change in RV function indices among hyperthyroid patients. Therefore, it highlights the necessity of early diagnosis and treatment of hyperthyroidism, as well as RV function evaluation in these patients.
由于甲状腺功能亢进症可能与右心室功能障碍有关，因此本研究旨在使用应变超声心动图在静息和最大应激状态下研究甲状腺功能亢进症患者的右心室（RV）功能。
本横断面研究于 2019 年 1 月至 2020 年 1 月在伊朗德黑兰 Rajaie 心血管医学和研究中心进行。所有研究参与者都完成了最大跑步机运动测试，以及静息和最大应激测试时的完整二维超声心动图。使用 SPSS 统计软件分析数据。对于数值数据使用独立样本 t 检验和曼-惠特尼 U 检验，对于名义数据使用卡方检验。P<0.05 为具有统计学意义。
最终分析包括 52 名参与者（每组 26 名受试者）。在最大应激情况下，我们发现 RV 整体纵向应变（P=0.0001）、收缩期应变率（P=0.0001）、舒张期应变率（P=0.0002）和三尖瓣环平面收缩期位移（P=0.019）在甲状腺功能亢进症患者中与对照组相比显著降低。此外，还发现 RV 大小与促甲状腺激素（TSH）水平之间存在线性相关（P=0.009，r=0.36）。此外，我们发现 TSH 水平与最大应激 RV 应变和舒张期应变率之间存在负线性相关（P<0.001）。
本研究结果表明甲状腺功能亢进症患者的 RV 功能指标发生了显著变化。因此，这强调了早期诊断和治疗甲状腺功能亢进症以及评估这些患者的 RV 功能的必要性。
