Impact of Disease Duration on Left Atrial Function in Patients with Graves’ Disease

Abstract Purpose: Graves’ disease, a common cause of hyperthyroidism, is associated with cardiovascular alterations. While its impact on left ventricular (LV) function has been studied, data on left atrial (LA) mechanics remain limited. This study aimed to investigate the relationship between disease duration and myocardial deformation parameters, including LA strain and LV global longitudinal strain (LV-GLS), using speckle-tracking echocardiography. Methods: In this cross-sectional study, 90 patients with Graves’ disease underwent comprehensive echocardiographic assessment. Based on median disease duration (<3 years and ≥3 years), patients were divided into two groups. LA reservoir strain (LASr), conduit strain (LAScd), contractile strain (LASct), and LV-GLS were measured. Results: Patients with longer disease duration showed significantly reduced LASr (36.9 ± 12.0% vs. 46.3 ± 11.0%, p = 0.001), LAScd (–20.2 ± 9.3% vs. –26.3 ± 9.4%, p = 0.007), LASct (–17.0 ± 6.4% vs. –19.9 ± 5.9%, p = 0.045), and LV-GLS (–21.7 ± 3.4% vs. –24.5 ± 3.9%, p = 0.002). Disease duration correlated negatively with LASr (r = –0.34, p < 0.001) and LV-GLS (r = 0.305, p = 0.003). Multivariate analysis identified LASr (OR = 1.054, 95% CI: 1.009–1.103, p = 0.019) and LV-GLS (OR = 1.190, 95% CI: 1.025–1.380, p = 0.022) as independent predictors of prolonged disease duration. Conclusion: Longer Graves’ disease duration is associated with subclinical atrial and ventricular dysfunction, detectable by strain imaging. These findings support the use of speckle-tracking echocardiography for early identification of cardiac involvement.