IntroductIon Thyroid hormone deficiency can lead to the impairment of cardiac function. objEctIvEs The aim of the study was to determine the left atrial (LA) mechanical function in patients with subclinical hypothyroidism (SHT) and overt hypothyroidism (OHT) and investigate associations of LA mechanical function with diastolic function.PAtIEnts And mEthods Twenty-six patients with newly diagnosed SHT (mean age, 42.2 ±12.5 years), 21 patients with OHT (40.2 ±8.5 years) and 28 healthy volunteers (42.4 ±11.2 years) were enrolled in this study. Patients were evaluated by standard M-mode echocardiographic measurements, mitral Doppler flow analysis, and tissue Doppler parameters at the lateral, septal, and right ventricular annuli. LA volumes were measured using the disc method, and the parameters of LA mechanical function were calculated.rEsuLts The active emptying volume (AEV) and active emptying fraction (AEF) were significantly higher in the OHT and SHT groups compared with controls. The passive emptying volume and passive emptying fraction were lower in the OHT and SHT groups compared with controls, but the differences were not significant. The conduit volume and the E/A ratio were significantly lower in the OHT and SHT groups compared with controls. The lateral and septal E/Em were significantly higher in the OHT and SHT groups than in the control group, but the septal Em/Am was significantly lower. Diastolic function parameters showed significant associations with AEV and AEF.concLusIons LA mechanical function is impaired in patients with thyroid dysfunction. Our findings suggest that this impairment is secondary to that of the left ventricular diastolic function.
KEy wordsdiastolic dysfunction, echocardiography, hypothyroidism, left atrial mechanical function orIGInAL ArtIcLE Assessment of left atrial mechanical functions in thyroid dysfunction 597 panels, and fasting glucose levels were measured using venous blood obtained after 8 hours of fasting. An informed consent was obtained from each participant. The study was approved by the local ethics committee.Echocardiographic examination Standard echocardiography was performed using a Vingmed Vivid System 5 device (General Electric, Horten, Norway). A 2.5 MHz probe was used for Doppler measurements and a 2.5-3.5 MHz probe was used for tissue Doppler measurements. All measurements represented an average taken from 3 cardiac cycles. Two-dimensional echocardiographic measurements (LV dimensions, wall thickness, and mitral inflow velocities) were performed were performed according to the standards published by the American Society of Echocardiography. 16 The LV ejection fraction was calculated according to the Simpson method.
17In order to obtain the best signal-to-noise ratio, LV pulsed-tissue Doppler imaging (TDI) was performed in the apical 4-chamber view using a 5-mm pulsed Doppler sample volume with as little optimal gain as possible. Care was taken to align the echo image so that the annular motion was parallel to the TDI cursor. Spectral pulsed-wave D...