Subclinical Myocardial Dysfunction Demonstrated by Speckle Tracking Echocardiography in Children with Euthyroid Hashimoto’s Thyroiditis

• Published in: Journal of clinical research in pediatric endocrinology 2019-12, Vol.11 (4), p.410-418
• Main Authors: Azak, Emine, Uçaktürk, Seyit Ahmet, Çetin, İbrahim İlker, Gürsu, Hazım Alper, Mengen, Eda, Pamuk, Utku
• Format: Article
• Language: English
• Subjects: Adolescent; Age Factors; Antibodies; Asymptomatic Diseases; Biomarkers - blood; Cardiovascular diseases; Case-Control Studies; Child; Child, Preschool; Children; Cross-Sectional Studies; Echocardiography; Echocardiography, Doppler; Female; Hashimoto Disease - blood; Hashimoto Disease - complications; Hashimoto Disease - diagnostic imaging; hashimoto’s thyroiditis; Heart diseases; Hormones; Humans; Laws, regulations and rules; Male; Myocardial Contraction; myocardial function; Original; Predictive Value of Tests; Risk Factors; speckle tracking echocardiography; Thyroid diseases; Thyroid hormones; Thyroid Hormones - blood; Thyroiditis; Tıp; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - etiology; Ventricular Dysfunction, Left - physiopathology; Ventricular Function, Left
• ISSN: 1308-5727; 1308-5735
• DOI: 10.4274/jcrpe.galenos.2019.2018.0273

Thyroid hormones have an important role in the regulation of the cardiovascular system. The aim of this study was to investigate the presence of subclinical myocardial dysfunction in children with euthyroid Hashimoto’s thyroiditis (eHT) without evident heart disease using tissue doppler imaging (TDI) and speckle tracking echocardiography (STE) methods. TDI and STE were peformed in 50 children with eHT and in 35 healthy children. To assess myocardial velocities and time intervals, including peak systolic velocity (S ), peak early diastolic velocity (E ), peak late diastolic velocity (A ), isovolumetric contraction time (IVCT), isovolumetric relaxation time (IVRT) and ejection time (ET), TDI was performed at the base of the interventricular septum (IVS) and in the left and right ventricles (LV and RV, respectively). Analysis of myocardial deformation by STE including strain (S) and strain rate (SR) was performed globally in two planes, longitudinal (L) and mid-circumferential (C) in LV [LV global longitudinal strain (LVGLS), LV global longitudinal strain rate (LVGLSR), LV global circumferential strain (LVGCS), LV global circumferential strain rate (LVGCSR)] and RV [(RV global longitudinal strain (RVGLS), RV global longitudinal strain rate (RVGLSR)]. Among TDI parameters, ET at LV and IVS were significantly lower, IVRT and myocardial performance index at LV and IVS were significantly higher in the eHT group compared to controls (p=0.001). There were no significant differences in S , E , A and IVCT values between patients and controls. LVGLS, LVGLSR, LVGCS and LVGCSR values were significantly lower in patients than controls (p=0.01). There was a negative correlation between thyroid antibody levels and LV global longitudinal and circumferential strain and strain rate values (TPO-Ab and Tg-Ab between LVGLS, LVGLSR, LVGCS and LVGCSR; r=-411, p