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Left and right ventricular functions may be impaired in children diagnosed with subclinical hypothyroidism

Alper Akın1, Edip Unal2, Ruken Yildirim2

  • 1Department of Pediatric Cardiology, Dicle University Faculty of Medicine, Sur, Diyarbakır, Turkey. alperakin1@hotmail.com.

Scientific Reports
|November 13, 2020
PubMed

Insights

Subclinical hypothyroidism (SH) in children can increase left ventricular mass index and impair both left and right ventricular functions, as shown by Tissue Doppler Imaging (TDI). TDI is effective in assessing these cardiac changes in pediatric SH.

Area of Science:

  • Pediatric Cardiology
  • Endocrinology
  • Diagnostic Imaging

Background:

  • Subclinical hypothyroidism (SH) is a condition where thyroid hormone levels are abnormal, but symptoms are not apparent.
  • SH may affect cardiac function, particularly in children, necessitating early detection and assessment.
  • Echocardiography, including Tissue Doppler Imaging (TDI), offers valuable insights into cardiac mechanics.

Purpose of the Study:

  • To evaluate the impact of subclinical hypothyroidism on ventricular functions in children using TDI and other echocardiographic methods.
  • To compare cardiac parameters between children with SH and healthy, euthyroid children.
  • To determine the utility of TDI in assessing cardiac effects of SH in pediatric populations.

Main Methods:

  • A comparative study involving 35 children diagnosed with SH and 38 age-matched euthyroid children.
  • Diagnosis of SH was based on elevated thyroid-stimulating hormone (TSH) levels (>4.2 mIU/L) with normal free thyroxine (FT4).
  • Echocardiography was performed, focusing on left ventricular mass index (LVMI) and various TDI parameters for both left and right ventricles.

Main Results:

  • Children with SH exhibited a significantly higher left ventricular mass index (LVMI) compared to controls (p=0.005).
  • Significant alterations in TDI parameters were observed in SH patients, including reduced mitral septal ejection time and increased mitral septal myocardial performance index.
  • Right ventricular function was also affected, with higher tricuspid lateral and septal E/Ea ratios and lower tricuspid septal Ea/Aa and ejection times in the SH group.

Conclusions:

  • Subclinical hypothyroidism in children is associated with increased LVMI.
  • Both systolic and diastolic functions of the left and right ventricles may be impaired in children with SH, as indicated by TDI findings.
  • TDI is a valuable diagnostic tool for evaluating the cardiac consequences of subclinical hypothyroidism in pediatric patients.

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