Echocardiographic evaluation of cardiac function in hypothyroidism

To study the clinical profile and various echocardiographic changes in hypothyroid patients and compare these changes between hypothyroid patients and controls. Methods: We included 32 consecutive first time detected hypothyroid patients diagnosed through thyroid profile and 15 healthy age and sex matched controls. The clinical electrocardiographic and echocardiographic features of the study group were compared to their respective age and sex matched healthy controls. Results: In current study, most of the patients (56.25%) had presented with pre-hypertension stage. Hypothyroid patients had significantly raise TSH and low T3 and T4 and also had raised serum cholesterol, triglyceride and LDL concentration as compared to controls. The sinus bradycardia was commonest electrocardiogram abnormality being present in 43.75% patients followed by low voltage complexes (18.75%), ST-T changes (15.62%) and right bundle branch block (3.1%) while 18.75% had normal electrocardiogram. There was no statistical difference in basic two dimensional echocardiographic parameters between two groups. We found significant reduction in early diastolic filling (E) with augmented late diastolic filling (A) resulting in decrease E/A ratio suggesting significant diastolic dysfunction associated with significant reduction in, peak early diastolic velocity (E'), raised peak late velocity (A') and increased E/E' in both overt and subclinical hypothyroid patients. IVRT and DT were also prolonged. Increased interventricular septal and posterior wall thickness was also found in overt hypothyroid along with pericardial effusion when compared to subclinical and controls. There was no significant difference observed in ejection fraction and systolic velocity between two groups. Conclusion: This study demonstrated that diastolic function was impaired in patients with hypothyroidism. Doppler-echocardiography may be considered a reliable method for a cross-sectional and longitudinal assessment of left ventricular diastolic function in patients with hypothyroidism.