Objective: In subclinical hypothyroidism (SH), impaired diastolic function has been documented at rest and on effort, while systolic dysfunction has only been assessed on effort. Design: The aim of the present study was: (a) to further assess systolic function at rest in SH; and (b) to ascertain whether cardiac dysfunction could precede TSH increase in euthyroid patients with a high risk of developing SH. Methods: We studied 32 patients with classical Hashimoto's thyroiditis (22 with increased serum TSH (.3 mU/ml -group A), and 10 with normal serum TSH (,3 mU/ml -group B)); a third group (C), which included 13 healthy controls. All subjects underwent pulsed wave tissue Doppler imaging (PWTDI) to accurately quantify the global and regional left ventricular function. Results: When compared with group C, PWTDI indices showed that in both groups A and B there was a significant impairment of systolic ejection (P , 0.001 and P , 0.05, respectively), a delay in diastolic relaxation (P , 0.001 and P , 0.05, respectively) and a decrease in the compliance to the ventricular filling (P , 0.05). Several significant correlations were found between PWTDI parameters and serum-free T 3 and T 4 and TSH concentrations. Conclusion: PWTDI is a sensitive technique that allows detection of both diastolic and systolic abnormalities, not only in patients with SH, but also in euthyroid subjects with a high risk of developing thyroid failure. Futhermore, the significant correlations of several PWTDI indices with serum FT 3 and TSH concentrations strongly support the concept of a continuum spectrum of a slight thyroid failure in autoimmune thyroiditis extending to subjects with serum TSH still within the normal range.

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Poster abstracts applied with slices of 2.2 mm, including 15 images for reviewing. Statistical analysis included contingency tables and reliability tests. Results: 10 cases of HBD and 10 of women without HBD (controls) were included in this study. Volumes could be captured in all cases. The average examination time was 5 minutes. The overall performance of the operators for 2D approach and TUI in the detection of IUD placement were: sensitivity 70%-100%; specificity 90%-100%; PPV 87%-100%; NPV 75%-90%. ROC curve analysis showed a better performance for TUI than the 2D approach: area under the curve of 0.95 vs 0.8. Reliability analysis showed a high correlation between operators (C.alpha = 0.95, p < 0.01). Conclusion: TUI technique is a sensitive and reliable method for the assessment of HBD. It is an easy method for in situ exploration, and may help to increase the detection rate of non copper-related devices.