2012
DOI: 10.1530/eje-11-0907
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Diagnosis of subclinical central hypothyroidism in patients with hypothalamic–pituitary disease by Doppler echocardiography

Abstract: Objective: The diagnosis of subclinical central hypothyroidism in hypothalamic-pituitary patients cannot be established by serum markers of thyroid hormone action. Myocardial function by echocardiography has been shown to reflect thyroid hormone action in primary thyroid dysfunction. We evaluated the performance of echocardiography in diagnosing subclinical central hypothyroidism. Design: Cross-sectional and before and after. Methods: Echocardiography and serum thyroid hormones were assessed in overt primary (… Show more

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Cited by 25 publications
(13 citation statements)
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“…Given the difficulty of diagnosis, determination of indexes of peripheral thyroid hormone action like sex hormone-binding globulin (SHBG), serum lipids or others, may support the existence of CCH [80]. In this line, recent reports suggest that T 3 -dependent parameters of Doppler echocardiography such as the isovolumic contraction time, isovolumic contraction time/ejection time and myocardial performance index correlate well with the presence of CCH in adult patients with hypothalamic-pituitary diseases, thus suggesting a diagnostic potential for 'hidden' CCH [84], yet unexplored in children.…”
Section: Identification Etiological Investigations and Clinical Manamentioning
confidence: 99%
“…Given the difficulty of diagnosis, determination of indexes of peripheral thyroid hormone action like sex hormone-binding globulin (SHBG), serum lipids or others, may support the existence of CCH [80]. In this line, recent reports suggest that T 3 -dependent parameters of Doppler echocardiography such as the isovolumic contraction time, isovolumic contraction time/ejection time and myocardial performance index correlate well with the presence of CCH in adult patients with hypothalamic-pituitary diseases, thus suggesting a diagnostic potential for 'hidden' CCH [84], yet unexplored in children.…”
Section: Identification Etiological Investigations and Clinical Manamentioning
confidence: 99%
“…In particular, in patients under follow-up for hypothalamic/pituitary disease, the diagnosis of mild forms of CeH should be considered when serum FT4 decreases from higher values into the lower quartile of the normal range, in particular when a FT4 decrease > 20% of previous values is seen despite a low or normal TSH (provided that the indices are measured in the same laboratory and by the same assay) [25]. In such context, an English group proposed the calculation of a TSH index based on the physiological log-linear relationship between circulating FT4 and TSH concentrations in a large reference population [46], and more recently a Brazilian group proposed the determination of echocardiographic parameters [47]. The relative application of the tests and findings reported in Table 4 depends upon the different settings and local regulations (Recommendations 10-14).…”
Section: How Can Ceh Be Diagnosed?mentioning
confidence: 99%
“…Very recently, the determination of parameters of Doppler echocardiography including the isovolumic contraction time, isovolumic contraction time/ejection time, and myocardial performance index were, however, demonstrated to correlate with the presence of CeH in a cohort of patients with hypothalamic-pituitary diseases, thus suggesting a potential use in the diagnosis of hidden CeH (Doin et al, 2012). Since abnormalities in cardiac parameters were reverted during L-T4 replacement, these findings may also indicate the requirement for L-T4 treatment even in milder forms of the disease, as previously claimed in subclinical primary hypothyroidism (Cooper and Biondi, 2012).…”
Section: Hartoftmentioning
confidence: 99%