Key result
Longer Graves' disease duration linked to ~20% lower left atrial reservoir strain versus shorter duration.
Why the study?
Graves' disease is associated with cardiovascular alterations, but data on left ventricular function and left atrial mechanics remain limited.
Does longer disease duration impair left atrial and ventricular mechanics in patients with Graves' disease?
Cross-Sectional (n=90)
Does longer disease duration impair left atrial and ventricular mechanics in patients with Graves' disease?
Absolute Event Rate: 36.9% vs 46.3%
p-value: p=0.001
Longer duration of Graves' disease is associated with progressive subclinical impairment of atrial and ventricular mechanics, detectable by speckle-tracking echocardiography even in euthyroid patients.
Hypothesis-generating for atrial monitoring in prolonged Graves' disease; prospective studies needed before practice change.
INTRODUCTION: Graves' disease is associated with cardiovascular alterations. Data on the left ventricular (LV) function and left atrial (LA) mechanics in Graves' disease remain limited. This study investigated the relationship between disease duration and myocardial deformation parameters, including LA strain and LV global longitudinal strain (LV-GLS). METHODS: In this cross-sectional study, 90 patients with Graves' disease underwent comprehensive echocardiographic assessment. Disease duration was classified as short (≤2 years) or long (>2 years) based on receiver operating characteristic analysis. LA reservoir strain (LASr), conduit strain (LAScd), contractile strain (LASct), and LV-GLS were measured. In addition, strain parameters were compared between patients according to thyroid status (euthyroid vs. hyperthyroid). 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 absolute LV-GLS (20.8% [18.4%-24.9%] vs. 24.3% [21.7%-27.4%], p = 0.007). Disease duration correlated negatively with LASr (r = -0.340, p < 0.001) and absolute LV-GLS (r = -0.311, p = 0.003). Multivariate analysis identified LASr (OR = 0.947, p = 0.017) and LV-GLS (OR = 0.838, p = 0.020) as independent predictors of prolonged disease duration. In euthyroid patients with longer disease duration, strain parameters were significantly lower than in hyperthyroid patients with shorter duration. CONCLUSION: Longer Graves' disease duration is associated with progressive subclinical impairment of atrial and ventricular mechanics, with strain abnormalities evident even in euthyroid patients. These findings highlight the cumulative impact of disease chronicity and support the use of speckle-tracking echocardiography for early detection of myocardial dysfunction and closer cardiovascular monitoring in this population.
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Murat et al. (2025) conducted a cross-sectional in Graves' disease (n=90). Long disease duration (>2 years) vs. Short disease duration (≤2 years) was evaluated on Left atrial reservoir strain (LASr) (p=0.001). Longer Graves' disease duration (>2 years) was associated with significantly reduced left atrial reservoir strain compared to shorter duration (36.9% vs. 46.3%, p=0.001).
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