Left and right ventricular functions may be impaired in children diagnosed with subclinical hypothyroidism

Akın, Alper; Ünal, Edip; Yıldırım, Ruken; Türe, Mehmet; Balık, Hasan; Haspolat, Yusuf Kenan

doi:10.1038/s41598-020-76327-4

Cited by 5 publications

(4 citation statements)

References 27 publications

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“…We also found that the combination of LVMI and RWT is predictive of the outcomes after LT in children with BA. Elevated LVMI and RWT are used to identify left ventricular hypertrophy (LVH), which has been related to poor outcomes, including death, in both adults and pediatric patients with cirrhosis, and has also been related to morbidity in other diseases (8,(18)(19)(20). At present, there are no established thresholds for determining LVH in children.…”

Section: Discussionmentioning

confidence: 99%

Subclinical cardiac abnormalities in children with biliary atresia correlate with outcomes after liver transplantation

Wei

Hao

et al. 2023

Front. Pediatr.

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ObjectiveThere are subclinical cardiac abnormalities (SCA) in children with biliary atresia (BA). However, data on the consequences of these cardiac changes after liver transplantation (LT) remain controversial in the pediatric field. We aimed to determine the relationship between outcomes and the subclinical cardiac abnormalities in pediatric patients with BA based on two-dimensional echocardiography (2DE) parameters.MethodsA total of 205 children with BA were enrolled in this study. The relationship between 2DE parameters and outcomes, including death and serious adverse events (SAE) after LT, was analyzed by regression analysis. Using receiver operator characteristic (ROC) curves to determine the optimal cut-off values of 2DE parameters for outcomes. Differences in the AUCs were compared using DeLong's test. The Kaplan -Meier method with log-rank testing was used to evaluate survival outcomes between groups.ResultsLeft ventricular mass index (LVMI) and relative wall thickness (RWT) were found to be independently associated with SAE (OR: 1.112, 95% CI: 1.061 − 1.165, P < 0.001 and OR: 1.193, 95% CI: 1.078 − 1.320, P = 0.001, respectively). The cutoff value of LVMI for predicting the SAE was 68 g/m2.7 (AUC = 0.833, 95% CI 0.727-0.940, P < 0.001), and the cutoff value of RWT for predicting the SAE was 0.41 (AUC = 0.732, 95% CI 0.641-0.823, P < 0.001). The presence of subclinical cardiac abnormalities (LVMI > 68 g/m2.7, and/or RWT > 0.41) was associated with lower patient survival (1-year, 90.5% vs 100.0%; 3-year, 89.7% vs 100.0, log-rank P = 0.001). and higher incidence of SAE events.ConclusionsSubclinical cardiac abnormalities were correlated with post-LT mortality and morbidity in children with BA. LVMI can predict the occurrence of death and serious adverse events after liver transplantation.

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Section: Discussionmentioning

confidence: 99%

Subclinical cardiac abnormalities in children with biliary atresia correlate with outcomes after liver transplantation

Wei

Hao

et al. 2023

Front. Pediatr.

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“…This result is consistent with that of another systematic evaluation based on echocardiography, cardiac magnetic resonance imaging, and myocardial radionuclide imaging, which found no significant morphological changes in the heart after treatment with levothyroxine in patients with SCH ( 30 ). Some studies have suggested that the LV mass of both adult and pediatric patients with SCH is significantly increased compared to that in the normal population ( 14 , 31 ) and that this increases with the duration of the disease among those with TSH≥10.0 ( 32 ). However, other studies have reported no significant association between SCH and LV mass ( 33 ).…”

Section: Discussionmentioning

confidence: 99%

Effect of thyroid hormone replacement treatment on cardiac diastolic function in adult patients with subclinical hypothyroidism: a meta-analysis

Liu,

Ren,

et al. 2023

Front. Endocrinol.

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BackgroundAlthough subclinical hypothyroidism (SCH) is related to abnormalities in left ventricular diastolic function, the use of levothyroxine as a regular treatment remains debatable. This meta-analysis aimed to determine whether thyroid hormone replacement therapy affects cardiac diastolic function in patients with SCH as measured by echocardiography.MethodsThis meta-analysis included a search of the EMBASE, PubMed, Web of Science, and Cochrane Library databases from their inception to May 18, 2023, for studies analyzing cardiac morphology and functional changes in patients with SCH before and after thyroid hormone replacement. The outcome measures were cardiac morphology and diastolic and overall cardiac function, as assessed using ultrasound parameters (including ventricular wall thickness, chamber size, mitral wave flow, tissue Doppler, and speckle tracking). The quality of the studies was assessed using the Newcastle–Ottawa Scale. The standard mean differences (MDs) and 95% confidence intervals (CI) were calculated using fixed- or random-effects models.ResultsSeventeen studies met the inclusion criteria. A total of 568 patients participated and completed the follow-up. All studies specifically stated that serum thyrotropin levels returned to normal by the end of the study period. Compared with baseline levels, no significant morphological changes were observed in the heart. In terms of diastolic function, we discovered that the ratios of E-velocity to A-velocity (E/A) had greatly improved after thyroid hormone replacement therapy, whereas the ratios of the mitral inflow E wave to the tissue Doppler e’ wave (E/e’) had not. Global longitudinal strain (GLS) increased significantly after treatment with levothyroxine.ConclusionIn adult patients with SCH, thyroid hormone supplementation can partially but not completely improve parameters of diastolic function during the observation period. This meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement, an updated guideline for reporting systematic reviews (11) and was registered with INPLASY (INPLASY202320083).Systematic review registrationhttps://inplasy.com/inplasy-2023-2-0083.

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“…Disorders of thyroid hormones are associated with myocardial infarction, decreased cardiac output, altered heart rate, increased systemic vascular resistance, cardiomyocyte atrophy, endothelial dysfunction, and increased prevalence of atherosclerosis and heart failure (8). It has been observed that subclinical hypothyroidism is associated with left ventricular systolic and diastolic dysfunction (9,10). Changes in thyroid hormone levels increase the hemodynamic load of the heart, which increases the heart rate and ultimately the size of the heart (11).…”

Section: Introductionmentioning

confidence: 99%

“…Endothelial-dependent vasodilation disorder has been reported as a result of nitric oxide reduction in subclinical hypothyroidism (15). The role of these hormones in heart failure has been identified, but limited studies have examined the systolic and diastolic ventricular disorders in detail (6,9,10,12).…”

Section: Introductionmentioning

confidence: 99%

Evaluation for the Relationship Between Normal Serum Level of Thyroid Hormones and Left Ventricular Systolic and Diastolic Dysfunction

Maghami

Alizadehasl

Khalili

et al. 2022

Multidiscip Cardio Annal

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Background: Thyroid hormones play an important role in cardiac tissue function. Therefore, it is important to understand the relationship between thyroid hormone levels and cardiac disorders. Objectives: The present study aimed to assess the relationship between normal serum level of thyroid hormones and left ventricular systolic and diastolic dysfunction. Methods: In this cross sectional descriptive retrospective study, 391 patients were selected. They were referred to the Rajaie Cardiovascular Research Center, Tehran, Iran from 2019 to 2021. After extracting echocardiographic and laboratory data from the clinical records, the parameters affecting the left ventricular systolic and diastolic dysfunction were analyzed using statistical software. Results: The mean age of patients was 41 ± 12.8 years. Among them 58.1% of all patients were female. Tricuspid regurgitation (TR) severity had a significant relationship with thyroid stimulating hormone (TSH) level (P = 0.02). End diastolic interventricular septum thickness (IVSD) was inversely associated with thyroxin4 (T4) level (P = 0.04). Mitral valve inflow deceleration time (MVDT) was inversely correlated with thyroxin3 (T3) (P = 0.04). Left ventricular ejection fraction (LVEF) was inversely related to TSH level and end diastolic right ventricular internal diameter (RVIDd) was directly related to TSH (P = 0.05). Conclusions: Thyroid hormone levels in the normal range can be associated with the tricuspid regurgitation severity, end diastolic right ventricular internal diameter (RVIDd), mitral valve inflow deceleration time (MVDT), and. end diastolic interventricular septum thickness (IVSD). Due to the high prevalence of heart disorders, information on thyroid hormone levels can be helpful in the identification and timely treatment of these disorders.

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Left and right ventricular functions may be impaired in children diagnosed with subclinical hypothyroidism

Cited by 5 publications

References 27 publications

Subclinical cardiac abnormalities in children with biliary atresia correlate with outcomes after liver transplantation

Subclinical cardiac abnormalities in children with biliary atresia correlate with outcomes after liver transplantation

Effect of thyroid hormone replacement treatment on cardiac diastolic function in adult patients with subclinical hypothyroidism: a meta-analysis

Evaluation for the Relationship Between Normal Serum Level of Thyroid Hormones and Left Ventricular Systolic and Diastolic Dysfunction

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