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Left Ventricular Longitudinal Myocardial Function in Overt Hypothyroidism: A Tissue Doppler Echocardiographic Study


Address for correspondence and reprint requests: Selma Kenar Tiryakioglu, M.D., Bursa Acibadem Hospital, Cardiology, Sümer sok. No. 1, 16110 Nilufer, Bursa, Turkey. Fax: +902242704400; E-mail:


Background: The aim of this study was to assess left ventricular (LV) myocardial regional function in overt hypothyroidism by use of tissue Doppler imaging and to compare the results to the hormonal profile and standard Doppler echocardiographic examination. Methods: Hypothyroidic (Group 1, n = 25) and euthyroidic patients (Group 2, n = 25) underwent transthorasic echocardiography, strain and strain rate imaging. Results: Standard echocardiography showed that patients with overt hypothyroidism had significantly longer isovolumic contraction time (IVCT) (P < 0.05), deceleration time (DT) (P = 0.014) and isovolumic relaxation time (IVRT) (P = 0.022). Tissue Doppler imaging showed that the mean peak systolic strain (SI) (16.47 ± 1.45 vs. 20.63 ± 1.51, P < 0.001), the mean peak systolic strain rate (SSR) (1.05 ± 0.13 vs. 1.47 ± 0.11, P < 0.001), the mean peak early diastolic strain rate (ESr) (1.72 ± 0.38 vs. 2.03 ± 0.25, P < 0.05) and the mean peak late diastolic strain rate (ASr) (1.22 ± 0.31 vs. 1.46 ± 0.32, P < 0.05) were significantly lower in Group 1 compared to Group 2. For all patients, the systolic strain and systolic strain rate parameters negatively correlated with thyroid stimulating hormone levels and positively correlated with the levels of free triiodothyronine (fT3) and free tetraiodothyronine (fT4). Conclusion: These results indicate that overt hypothyroidism is associated with early impairment in LV longitudinal myocardial function, and that tissue Doppler echocardiography is useful for the grading of disease and detection of early impairment. (ECHOCARDIOGRAPHY 2010;27:505-511)

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