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The advantage of the use of echocardiographic evaluation in hypothyroid patients
Authors examined 10 patients with untreated myxoedema. The disease lasted at least one year in seven cases. The etiology of disease was autoaggressive thyroiditis in 9 cases and was diagnosed by a high titre of antibodies against thyroglobulin. The levels of T4 and T3 were low in all cases, level of TSH was elevated. The mean level of T4 was 0.91 microgram/dl, of T3 43.5 ng/dl. The level of TSH was over 96 microU/ml in 7 cases, in rest over 54 microU/ml. In all cases ECHO examination was done: pericardial effusion was proved in 80%. 5 patients were followed during substitutional therapy. Clinical signs and laboratory test normalised in all 5 cases. ECHO finding improved: left ventricular SEF from 54.4 +/- 7.4% to 67.9 +/- 10.3%, Vcf 0.82 +/- 16 circ/sec to 1.32 +/- 0.37 circ/sec max PWVs from 43.8 +/- 6.8 mm/sec to 63.2 +/- 9.9 mm/sec. The etiology of myxoedema may play a role in the incidence of pericardial effusion either by influence of autoaggressive disease or, which seems more probable, by a complete failure of thyroid gland secretion with low not only T4 but T3, too. T3 receptors are supposed to play an important role in the myxoedema heart disease.
Authors examined 10 patients with untreated myxoedema. The disease lasted at least one year in seven cases. The etiology of disease was autoaggressive thyroiditis in 9 cases and was diagnosed by a high titre of antibodies against thyroglobulin. The levels of T4 and T3 were low in all cases, level of TSH was elevated. The mean level of T4 was 0.91 microgram/dl, of T3 43.5 ng/dl. The level of TSH was over 96 microU/ml in 7 cases, in rest over 54 microU/ml. In all cases ECHO examination was done: pericardial effusion was proved in 80%. 5 patients were followed during substitutional therapy. Clinical signs and laboratory test normalised in all 5 cases. ECHO finding improved: left ventricular SEF from 54.4 +/- 7.4% to 67.9 +/- 10.3%, Vcf 0.82 +/- 16 circ/sec to 1.32 +/- 0.37 circ/sec max PWVs from 43.8 +/- 6.8 mm/sec to 63.2 +/- 9.9 mm/sec. The etiology of myxoedema may play a role in the incidence of pericardial effusion either by influence of autoaggressive disease or, which seems more probable, by a complete failure of thyroid gland secretion with low not only T4 but T3, too. T3 receptors are supposed to play an important role in the myxoedema heart disease.