Vekoska Nakova, Valentina and Krstevska, Brankica and Srbinovska Kostovska, Elizabeta and Vaskova, Olivija and Georgievska Ismail, Ljubica (2018) The effect of levothyroxine treatment on left ventricular function in subclinical hypothyroidism. Archives of Endocrinology and Metabolism - AE&M , 62 (4). pp. 392-398. ISSN 2359-3997; 2359-4292 online
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Abstract
Objective: Treatment of subclinical hypothyroidism (ScH), especially the mild form of ScH, is
controversial because thyroid hormones influence cardiac function. We investigate left ventricular
systolic and diastolic function in ScH and evaluate the effect of 5-month levothyroxine treatment.
Subjects and methods: Fifty-four patients with newly diagnosed mild ScH (4.2 < TSH < 10.0 mU/L) and
30 euthyroid subjects matched by age were analysed. Laboratory analyses and an echocardiography
study were done at the first visit and after 5 months in euthyroid stage in patients with ScH. Results:
Compared to healthy controls, patients with ScH had a lower E/A ratio (1.03 ± 0.29 vs. 1.26 ± 0.36, p <
0.01), higher E/e’ sep. ratio (7.62 ± 2.29 vs. 6.04 ± 1.64, p < 0.01), higher myocardial performance index
(MPI) (0.47 ± 0.08 vs. 0.43 ± 0.07, p < 0.05), lower global longitudinal strain (GLS) (-19.5 ± 2.3 vs. -20.9 ±
1.7%, p < 0.05), and lower S wave derived by tissue Doppler imaging (0.077 ± 0.013 vs. 0.092 ± 0.011 m/s,
p < 0.01). Levothyroxine treatment in patients with ScH contributed to higher EF (62.9 ± 3.9 vs. 61.6 ±
4.4%, p < 0.05), lower E/e’ sep. ratio (6.60 ± 2.06 vs. 7.62 ± 2.29, p < 0.01), lower MPI (0.43 ± 0.07 vs. 0.47 ±
0.08%, p < 0.01), and improved GLS (-20.07 ± 2.7 vs. -19.55 ± 2.3%, p < 0.05) compared to values in ScH
patients at baseline. Furthermore, in all study populations (ScH patients before and after levothyroxine
therapy and controls), TSH levels significantly negatively correlated with EF (r = -0.15, p < 0.05), E/A (r
= -0.14, p < 0.05), GLS (r = ‑0.26, p < 0.001), and S/TDI (r = -0.22, p < 0.01) and positively correlated with
E/e’ sep. (r = 0.14, p < 0.05). Conclusion: Patients with subclinical hypothyroidism versus healthy
individuals had subtle changes in certain parameters that indicate involvement of systolic and
diastolic function of the left ventricle. Although the values of the parameters were in normal range,
they were significantly different compared to ScH and the control group at baseline, as well as to the
ScH groups before and after treatment. The results of our study suggest that patients with ScH must be
followed up during treatment to assess improvement of the disease. Some of the echocardiography
obtained parameters were reversible after levothyroxine therapy.
| Item Type: | Article |
|---|---|
| Impact Factor Value: | 1.571 |
| Subjects: | Medical and Health Sciences > Clinical medicine |
| Divisions: | Faculty of Medical Science |
| Depositing User: | Valentina Velkovska |
| Date Deposited: | 28 May 2020 08:21 |
| Last Modified: | 28 May 2020 08:21 |
| URI: | https://eprints.ugd.edu.mk/id/eprint/24063 |
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