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Updated: May 6, 2026

Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Left and right ventricular structure and function in subclinical hypothyroidism: the effects of one-year
Sanja Ilic1, Marijana Tadic, Branislava Ivanovic
1Department of Endocrinology, University Clinical Hospital Center "Dr Dragisa Misovic", Belgrade, Serbia.
Insights
Subclinical hypothyroidism significantly impairs heart function and mechanics in both left and right ventricles. Levothyroxine treatment effectively improves cardiac structure and function in affected patients.
Area of Science:
- Cardiology
- Endocrinology
- Medical Research
Background:
- Subclinical hypothyroidism (SHT) is associated with cardiovascular changes.
- Investigating cardiac structure and function in SHT is crucial.
Purpose of the Study:
- To assess left ventricular (LV) and right ventricular (RV) structure, function, and mechanics in SHT patients.
- To evaluate the impact of levothyroxine treatment on cardiac parameters in SHT.
Main Methods:
- Comparison of 45 untreated SHT women with 35 healthy controls.
- Laboratory analyses including thyroid hormone levels (free T3, free T4, TSH).
- Complete 2-dimensional echocardiographic study and 1-year follow-up post-levothyroxine therapy.
Main Results:
- SHT patients showed increased LV mass index and impaired LV systolic, diastolic, and global function (Tei index).
- RV wall thickness was increased, with impaired RV diastolic and global function in SHT patients.
- Levothyroxine therapy significantly improved LV and RV structure, function, and mechanics.
Conclusions:
- Subclinical hypothyroidism detrimentally affects LV and RV structure, function, and mechanics.
- Levothyroxine replacement therapy demonstrates significant benefits in restoring cardiac health in SHT patients.
Background:
The aim of this study was to investigate left ventricular (LV) and right ventricular (RV) structure, function, and mechanics in patients with subclinical hypothyroidism (SHT), and to evaluate the effect of a 1-year levothyroxine treatment.
Material And Methods:
We compared 45 untreated women with subclinical hypothyroidism and 35 healthy control women matched by age. All the subjects underwent laboratory analyses, which included a thyroid hormone levels (free T3, free T4, and TSH) test, and a complete 2-dimensional echocardiographic study. All the SHT patients received levothyroxine therapy and were followed for a year after euthyroid state was achieved.
Results:
The LV mass index in the SHT participants before and after replacement therapy was significantly higher than in controls. In the SHT patients before the treatment, LV diastolic function and global function estimated by the Tei index were significantly impaired, whereas the LV systolic function was decreased. The results show that LV mechanics was significantly impaired in the SHT patients at baseline. Additionally, the SHT participants before levothyroxine substitution had increased RV wall thickness and significantly impaired RV diastolic and global function in comparison with the controls or the SHT subjects after the treatment. Furthermore, RV mechanics was also significantly deteriorated in the SHT patients before the treatment.
Conclusions:
Subclinical hypothyroidism significantly affected LV and RV structure, systolic, diastolic and global function, and LV and RV mechanics. Levothyroxine replacement therapy significantly improved cardiac structure, function, and mechanics in the SHT patients.
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