Correlation exists between serum TSH and doppler echocardiography findings regarding diastolic dysfunction of left ventricle
Journal Title: Medpulse International Journal of Biochemistry - Year 2019, Vol 10, Issue 1
Abstract
Problem statement: The heart is affected by thyroid hormone, and it’s could be adverse cardiac effects in thyroid disorder. Thyroid dysfunction itself exists in a wide range – from hyperthyroid state to hypothyroid with subclinical hyperthyroidism and subclinical hypothyroidism in between. Clinically, apparent illness in the extreme two disorders can easily seek medical attention. The problem exists in dealing with the subclinical dysfunctions. Methods: Patients were admitted in the department of Medicine. And all the biochemical parameters have been done in the department of Biochemistry. in M.G.M Medical College and L.S.K. Hospital. One hundred and fifteen patients were selected from our Medicine outdoor and indoor medical wards. After selection they were evaluated by Doppler echocardiography study. Among 115 patients, 50 patients were found to have Echo-doppler criteria of left ventricular diastolic dysfunction. These 50 patients were finally selected for the study. It was case and control study. Result: One hundred and fifteen patients with overt hypothyroidism were studied by echo doppler, among which fifty patients with Echo Doppler criteria of left ventricular diastolic dysfunction were finally selected for our study. We lost follow- up of 8 patients during our study before the first assessment. Fifty age and sex matched normal persons served as a control group. Mean age of our study group was 38.52 + 5.08 years. Serum TSH level showed a significant decrease in our patients from 51.33 + 30(m Iu/L) to 4.41 + 1.7 (mIu/L) after 3 months of L- thyroxine therapy. Serum T3 and T4 showed a significant rise in our patients from 0.85 + 0.84 (nmol/L) to 2.14 + 0.61 (nmol/L) and 43.64 + 16.37 (nmol/L) to 92.13 + 18.35 (nmol/L). Conclusion: The probable mechanism of improvement of left ventricular diastolic dysfunction in the early part of thyroxine replacement therapy was due to biochemical changes i.e. induction of calcium ATPase by L-thyroxine in sarcoplasmic reticulum of myocardial cells. The subsequent improvement in the overall diastolic function of left ventricle was possibly related to continued biochemical and associated structural changes in the myocardium. However a long term follow-up is required in this aspect.
Authors and Affiliations
Debjit Mitra, Shiv Shankar Bharti
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