Myocardial Strain and Diastolic Functions are Impaired in Treatment-Naive Papillary Thyroid Carcinoma Patients

Abstract Purpose Papillary thyroid carcinoma (PTC) may contribute to cardiovascular (CV) morbidity through pro-inflammatory signaling, endothelial dysfunction, and altered thyroid hormone pathways, yet subclinical myocardial effects remain poorly characterized. To evaluate subclinical myocardial dysfunction in treatment-naive, euthyroid PTC patients and investigate associations with integrin αvβ3 levels and central thyroid hormone resistance. Methods This case-control study included 36 untreated PTC patients and 20 benign nodular goiter controls. Comprehensive cardiac assessment utilized transthoracic echocardiography, tissue Doppler imaging, and two-dimensional speckle-tracking echocardiography. Serum integrin αvβ3 and tumor necrosis factor-alpha (TNF-α) levels were quantified via enzyme-linked immunosorbent assay. Central thyroid hormone sensitivity was assessed using the Thyroid Feedback Quantile-based Index (TFQI). Results PTC patients demonstrated significant subclinical cardiac dysfunction, including impaired left ventricular diastolic function and reduced myocardial contractility, as evidenced by compromised global longitudinal strain (GLS). Serum integrin αvβ3 and TNF-α levels were significantly elevated in PTC patients. Importantly, multivariable regression analysis revealed that elevated integrin αvβ3 was independently associated with impaired GLS (β = 0.412, P = 0.004) and diastolic dysfunction (RR = 1.101, 95% CI: 1.012–1.199, P = 0.026). TFQIFT4 levels were increased in PTC patients and notably showed a positive correlation with circulating integrin αvβ3 concentrations as well as an independent association with impaired GLS. Conclusions This study provides first evidence of subclinical CV dysfunction in treatment-naive PTC patients. Elevated integrin αvβ3 levels and central thyroid hormone resistance may synergistically contribute to early myocardial injury, highlighting the systemic cardiometabolic impact of PTC. Integrin αvβ3 emerges as a promising biomarker for CV risk stratification in PTC patients.