Document Detail


Abnormal cardiac contractility in long-term exogenous subclinical hyperthyroid patients as demonstrated by two-dimensional echocardiography speckle tracking imaging.
MedLine Citation:
PMID:  20587582     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Subclinical hyperthyroidism is associated with cardiovascular morbidity. Recent advances in echocardiography imaging have allowed sophisticated evaluation of myocardial tissue properties. OBJECTIVE: To investigate the myocardial effects of long-term exogenous subclinical hyperthyroidism using two-dimensional speckle tracking echocardiography imaging (2D-STE). DESIGN: Prospective, single-blinded, placebo-controlled randomized trial of 6 months duration with two parallel groups. PATIENTS AND METHODS: Totally 25 patients with a history of differentiated thyroid carcinoma on long-term TSH-suppressive levothyroxine (l-T(4)) substitution were randomized to persistent TSH-suppressive l-T(4) substitution (low-TSH group) or restoration of euthyroidism. Additionally 40 euthyroid controls were studied. RESULTS (PROPOSAL): At baseline, the group of patients showed normal left ventricular (LV) systolic function but impaired diastolic function as assessed with conventional echocardiographic parameters. Importantly, 2D-STE analysis demonstrated the presence of subclinical LV systolic and diastolic dysfunction with impaired circumferential and longitudinal strain and strain rate at the isovolumic relaxation time. After restoration of euthyroidism, a significant improvement in LV systolic and diastolic function as assessed with 2D-STE strain was observed. CONCLUSION: Prolonged subclinical hyperthyroidism leads to systolic and diastolic dysfunction, which is reversible after restoration of euthyroidism. 2D-STE is a more sensitive technique to evaluate subtle changes in LV performance of these patients.
Authors:
Randa M Abdulrahman; Victoria Delgado; Arnold C T Ng; See Hooi Ewe; Matteo Bertini; Eduard R Holman; Guido C Hovens; Alberto M Pereira; Johannes A Romijn; Jeroen J Bax; Johannes W Smit
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2010-06-29
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  163     ISSN:  1479-683X     ISO Abbreviation:  Eur. J. Endocrinol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-18     Completed Date:  2010-09-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  England    
Other Details:
Languages:  eng     Pagination:  435-41     Citation Subset:  IM    
Affiliation:
Department of Endocrinology and Metabolism, C4-R, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Pressure
Cohort Studies
Echocardiography / methods
Female
Follow-Up Studies
Humans
Hyperthyroidism / complications,  physiopathology*,  ultrasonography*
Male
Middle Aged
Myocardial Contraction / physiology*
Prospective Studies
Single-Blind Method
Time Factors
Ventricular Dysfunction, Left / etiology,  physiopathology*,  ultrasonography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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