[Cardiovascular remodelling in patients with sub-clinical hypothyroidism]

Sub-clinical hypothyroidism is defined by elevated serum thyroid-stimulating hormone level in the face of normal free thyroid hormone values. The role of sub-clinical hypothyroidism as independent risk factor for atherosclerosis has been suggested by clinical studies which demonstrated a higher prevalence of peripheral arterial disease, aortic atherosclerosis and coronary artery disease, in patients affected by this pathological condition. This association have been confirmed by the assessment of subclinical atherosclerosis by means of B-mode ultrasonography. Using this method an higher intima-media thickness (IMT) of carotid artery, a close marker of early atherosclerosis changes, have been found in patients with subclinical hypothyroidism compared to control euthyroid subjects. Levothyroxine replacement therapy of sub-clinical hypothyroidism was able to improve both the carotid IMT and atherogenic lipid profile, suggesting that lipid infiltration of the endothelium may represent a mechanism underlying the atherosclerotic process in patients with this pathological condition. Morphologic and functional changes of the myocardial tissue has been also demonstrated in patients with sub-clinical hypothyroidism, using ultrasonic backscatter video densitometry. All these data provide evidence of cardiovascular remodelling in patients with sub-clinical hypothyroidism. Vascular remodelling in sub-clinical hypothyroidism patients could be also studied by means of backscatter analysis of carotid artery, a method which allows the assessment of vascular sclerosis. Our preliminary results using this method suggested that not only atherosclerosis by also sclerosis characterises vascular remodelling in sub-clinical hypothyroidism patients.