Myocardial Diastolic Function and Arterial Elasticity in Patients with Autoimmune Thyroiditis and Subclinical Hypothyroidism

Abstract

AIM: to evaluate global and segmental myocardial diastolic function, vascular wall elasticity, and the relation of arterial compliance to diastolic dysfunction in patients with SH. METHODS. We studied global and regional diastolic function of left and right ventricles (LV and RV) by tissue Doppler imaging (TDI), arterial stiffness by ultrasound assessment of Young`s elastic modulus, as well as biochemical parameters in 50 middle-aged women. 14 of them were euthyroid and had endemic goiter (controls), 11 women were euthyroid but had autoimmune thyroiditis (AT), 25 patients had AT and subclinical hypothyroidism (SH). RESULTS. Patients with SH compared with euthyroid patients and controls exhibited lower Em/Am (p = 0.060) and Et/At (p = 0.034) values, increased prevalence of segmental LV diastolic dysfunction (p = 0.030) and higher Young`s elastic modulus (p = 0.049) indicating impaired global and regional diastolic function as well as increased arterial stiffness. Em/Am and Et/At ratio negatively correlated with age, TSH, LDL cholesterol values and Young`s modulus suggesting that RV and LV diastolic function was more changed in older, hypothyroid patients and by dislipidemia. Young`s elastic modulus values were positively correlated with the number of dysfunctional segments by TDI, cholesterol values and negatively with T4 values. CONCLUSIONS SH is associated with the impairment of global and regional diastolic function of RV and LV, and with increased arterial wall stiffness. There may be a common pathophysiological pathway linking these two entities. Dislipidemia and atherosclerosis acceleration can contribute, at least partly, to the cardiovascular abnormalities.