Key result
Levothyroxine therapy in subclinical hypothyroidism improved cardiac structure and function in treated individuals, though no differences in basic echocardiographic parameters were found versus controls.
Why the study?
Controversies persist regarding treating subclinical hypothyroidism with TSH < 10 mU/L due to a lack of evidence of levothyroxine's beneficial effects, prompting evaluation of its impact on cardiac morphology and function.
Does levothyroxine replacement therapy improve cardiac morphology and function in patients with subclinical hypothyroidism?
Observational
Does levothyroxine replacement therapy improve cardiac morphology and function in patients with subclinical hypothyroidism?
Levothyroxine replacement therapy in subclinical hypothyroidism may improve cardiac structure and function as assessed by echocardiography and electrocardiography.
May support levothyroxine for cardiac parameters in subclinical hypothyroidism; hypothesis-generating and requires RCTs versus controls.
Current controversies related to the treatment of subclinical hypothyroidism (SCH) with thyrotropin (TSH) < than 10 mU/L are based on the lack of evidence that levothyroxine therapy has beneficial effects. The aim of our study is to estimate the effect of levothyroxine treatment on cardiac morphology and function in subclinical hypothyroidism. Body mass index, waist circumference, blood pressure, electrocardiographic and standard echocardiographic parameters were measured before levothyroxine therapy and 3 months after TSH normalization. Significant reduction in systolic and diastolic blood pressure, PR, QT and QT corrected intervals, as well as increase in heart rate were recorded in the group on levothyroxine therapy. The following parameters of the left and right ventricle were significantly decreased in the treatment group: left ventricular mass index and volume, systolic and diastolic time intervals, and mitral annular plane systolic excursion (MAPSE). The increase was recorded as fractional shortening and pressure rise in early systole (dP/dt), right atrial wall thickness and diameters. Our study did not confirm differences in basic echocardiographic parameters between the treated and control groups, apart from an echocardiographic improvement of cardiac structure and function in treated individuals. The findings suggest electrocardiographic and echocardiographic screening in monitoring the therapeutic effect.
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Pandrc et al. (2020) conducted an observational in subclinical hypothyroidism. levothyroxine vs. control group was evaluated on cardiac morphology and function. Levothyroxine therapy in subclinical hypothyroidism improved cardiac structure and function in treated individuals, though no differences in basic echocardiographic parameters were found versus controls.
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