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How Does Subclinical Hyperthyroidism Affect Right Heart Function and Mechanics?

Marijana Tadic1, Vera Celic2, Cesare Cuspidi2

  • 1Departments of Cardiology (M.T., V.C., V.Z., T.M.) and Endocrinology (S.I.), University Clinical Hospital Center Dr Dragisa Misovic-Dedinje, Belgrade, Serbia; School of Medicine, University of Belgrade, Serbia (M.T., V.C., V.Z.); and Clinical Research Unit, University of Milan-Bicocca and Istituto Auxologico Italiano, Meda, Italy (C.C.). marijana_tadic@hotmail.com.

Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine
|December 31, 2015
PubMed
Summary

Subclinical hyperthyroidism impairs right heart function, affecting both the right ventricle and atrium. Thyroid-stimulating hormone levels correlate with these mechanical changes, indicating a link between thyroid status and cardiac health.

Keywords:
2-dimensional speckle tracking3-dimensional echocardiographyechocardiographyright ventriclesubclinical hyperthyroidism

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Area of Science:

  • Cardiology
  • Endocrinology
  • Medical Imaging

Background:

  • Subclinical hyperthyroidism, a state of suppressed thyrotropin (TSH) with normal free thyroid hormone levels, may affect cardiovascular function.
  • Right heart function and mechanics are crucial for overall cardiovascular health but remain understudied in subclinical hyperthyroidism.

Purpose of the Study:

  • To investigate right ventricular (RV) and right atrial (RA) function and deformation in individuals with subclinical hyperthyroidism.
  • To utilize advanced echocardiographic techniques, including 3-dimensional echocardiography (3DE) and 2-dimensional speckle-tracking echocardiography (2DE), for comprehensive assessment.

Main Methods:

  • A study involving 39 women with untreated subclinical hyperthyroidism and 39 age-matched healthy controls.
  • Comprehensive laboratory analyses of thyroid hormone levels and detailed 2DE and 3DE examinations were performed on all participants.

Main Results:

  • Patients with subclinical hyperthyroidism exhibited significantly elevated 3DE RV volumes and reduced 3DE RV ejection fraction (borderline significance).
  • Reduced 2DE RV and RA longitudinal strain, altered RV systolic and early diastolic strain rates, and increased late diastolic strain rates were observed.
  • Thyrotropin (TSH) levels showed correlations with various echocardiographic parameters of both left and right heart function, including RV and RA mechanics.

Conclusions:

  • Subclinical hyperthyroidism is associated with significant impairment in right ventricular and right atrial function and mechanics, as assessed by 3DE and 2DE.
  • Thyroid-stimulating hormone (TSH) levels are correlated with parameters reflecting right heart function and mechanics in the studied population.