Original Article

The subclinical Myocardial Dysfunction in Children with Euthyroid Hashimoto's Thyroiditis Demonstrated by Speckle Tracking Echocardiography

10.4274/jcrpe.galenos.2019.2018.0273

  • Emine Azak
  • Seyit Ahmet Ucakturk
  • Ibrahim Ilker Cetin
  • Hazım Alper Gursu
  • Eda Mengen
  • Utku Pamuk

Received Date: 20.11.2018 Accepted Date: 19.06.2019 J Clin Res Pediatr Endocrinol 0;0(0):0-0 [e-Pub] PMID: 31218876

Objectives:

Thyroid hormone plays an important role in regulation of cardiovascular system. The aim of this study was to evaluated whether there is myocardial subclinical dysfunction or not in children with euthyroid Hashimoto's thyroiditis (eHT) without an obvious heart disease by using tissue Doppler imaging (TDI) and speckle tracking echocardiography (STE) methods.

Methods:

We performed TDI and STE in 50 children with eHT and 35 healthy children. TDI was performed at the base of interventricular septum (IVS), left ventricle (LV) and right ventricle (RV) to assess myocardial velocities and time intervals [peak systolic velocity (Sm), peak early diastolic velocity (Em), peak late diastolic velocity (Am), isovolumetric contraction time (IVCT), isovolumetric relaxation time (IVRT) and ejection time (ET)]. The analysis of myocardial deformation by STE [strain (S) and strain rate (SR)] was performed globally in two planes [longitudinal (L) and mid-circumferential (C)] in left ventricle [left ventricle global longitudinal strain (LVGLS), left ventricle global longitudinal strain rate (LVGLSR), left ventricle global circumferential strain (LVGCS), left ventricle global circumferential strain rate (LVGCSR)] and right ventricle [(right ventricle global longitudinal strain (RVGLS), right ventricle global longitudinal strain rate (RVGLSR)].

Results:

Among TDI parameters, ET at LV and IVS were significantly lower, IVRT and myocardial performance index (MPI) at LV and IVS were significantly higher in eHT group compared to controls. There were no significant differences in Sm, Em, Am and IVCT values between patients and controls. The LVGLS, LVGLSR, LVGCS and LVGCSR values were significantly lower in patients than controls. There was a negative correlation between thyroid antibody levels and LV global longitudinal and circumferential strain and strain rate values.

Conclusions:

Conventional echocardiography does not exclude subclinical LV wall motion abnormalities in asymptomatic patients with eHT. The results show that myocardial function in children with eHT has impaired in the absence of any clinical symptoms and conventional echocardiography is inadequate to determine these changes.

Keywords: Hashimoto’s thyroiditis, myocardial function, speckle tracking echocardiography, children