Does subclinical hypothyroidism affect cardiac pump performance? Evidence from a magnetic resonance imaging study

Andrea Ripoli, Alessandro Pingitore, Brunella Favilli, Antonio Bottoni, Stefano Turchi, Nael Fakhry Osman, Daniele De Marchi, Massimo Lombardi, Antonio L'Abbate, Giorgio Iervasi

Research output: Contribution to journalArticle

Abstract

We sought to assess the effects of subclinical hypothyroidism (SHT) on the cardiac volumes and function. The cardiovascular system is one of the principal targets of thyroid hormones. Subclinical hypothyroidism is a common disorder that may represent "early" thyroid failure. Thyroid profile was evaluated in 30 females with SHT and 20 matched control subjects. Left ventricular end-diastolic volume (EDV) and end-systolic volume (ESV), stroke volume (SV), cardiac index (CI), and systemic vascular resistance (SVR) were calculated by cardiac magnetic resonance (CMR). Regional greatest systolic lengthening (E1) and greatest systolic shortening (E2) were calculated by tagging CMR. EDV was lower in SHT than in controls (64.3 ± 8.7 ml/m 2 vs. 81.4 ± 11.3 ml/m 2, p <0.001), as well as SVR (38.9 ± 7.5 ml/m 2 vs. 52.5 ± 6.1 ml/m 2, p <0.001) and CI (2.6 ± 0.5 l/[min·m 2] vs. 3.7 ± 0.4 l/[min·m 2], p <0.001). Systemic vascular resistance was higher in SHT (12.5 ± 2.5 mm Hg·min/ [l·m 2] vs. 8.6 ± 1.1 mm Hg·min/[l·m 2], p = 0.003). The E1 was higher in controls than in SHT at the basal (p = 0.007), equatorial (p = 0.05), and apical (p = 0.008) levels, as well as E2 at the equatorial (p = 0.001) and apical (p = 0.001) levels. All parameters normalized after replacement therapy. A negative correlation between TSH and EDV (p <0.001), SV (p <0.001), CI (p <0.001), and E1 at the apical level (p <0.001) and a positive correlation between TSH and SVR (p <0.001) and E2 at the apical level (p <0.001) were found. Subclinical hypothyroidism significantly decreased cardiac preload, whereas it increased afterload with a consequent reduction in SV and cardiac output. Replacement therapy fully normalized the hemodynamic alterations.

Original languageEnglish (US)
Pages (from-to)439-445
Number of pages7
JournalJournal of the American College of Cardiology
Volume45
Issue number3
DOIs
StatePublished - Feb 1 2005

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Hypothyroidism
Magnetic Resonance Imaging
Vascular Resistance
Stroke Volume
Thyroid Gland
Magnetic Resonance Spectroscopy
Cardiac Volume
Cardiovascular System
Thyroid Hormones
Cardiac Output
Hemodynamics
Therapeutics

ASJC Scopus subject areas

  • Nursing(all)

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Does subclinical hypothyroidism affect cardiac pump performance? Evidence from a magnetic resonance imaging study. / Ripoli, Andrea; Pingitore, Alessandro; Favilli, Brunella; Bottoni, Antonio; Turchi, Stefano; Osman, Nael Fakhry; De Marchi, Daniele; Lombardi, Massimo; L'Abbate, Antonio; Iervasi, Giorgio.

In: Journal of the American College of Cardiology, Vol. 45, No. 3, 01.02.2005, p. 439-445.

Research output: Contribution to journalArticle

Ripoli, A, Pingitore, A, Favilli, B, Bottoni, A, Turchi, S, Osman, NF, De Marchi, D, Lombardi, M, L'Abbate, A & Iervasi, G 2005, 'Does subclinical hypothyroidism affect cardiac pump performance? Evidence from a magnetic resonance imaging study', Journal of the American College of Cardiology, vol. 45, no. 3, pp. 439-445. https://doi.org/10.1016/j.jacc.2004.10.044
Ripoli, Andrea ; Pingitore, Alessandro ; Favilli, Brunella ; Bottoni, Antonio ; Turchi, Stefano ; Osman, Nael Fakhry ; De Marchi, Daniele ; Lombardi, Massimo ; L'Abbate, Antonio ; Iervasi, Giorgio. / Does subclinical hypothyroidism affect cardiac pump performance? Evidence from a magnetic resonance imaging study. In: Journal of the American College of Cardiology. 2005 ; Vol. 45, No. 3. pp. 439-445.
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AU - Turchi, Stefano

AU - Osman, Nael Fakhry

AU - De Marchi, Daniele

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N2 - We sought to assess the effects of subclinical hypothyroidism (SHT) on the cardiac volumes and function. The cardiovascular system is one of the principal targets of thyroid hormones. Subclinical hypothyroidism is a common disorder that may represent "early" thyroid failure. Thyroid profile was evaluated in 30 females with SHT and 20 matched control subjects. Left ventricular end-diastolic volume (EDV) and end-systolic volume (ESV), stroke volume (SV), cardiac index (CI), and systemic vascular resistance (SVR) were calculated by cardiac magnetic resonance (CMR). Regional greatest systolic lengthening (E1) and greatest systolic shortening (E2) were calculated by tagging CMR. EDV was lower in SHT than in controls (64.3 ± 8.7 ml/m 2 vs. 81.4 ± 11.3 ml/m 2, p <0.001), as well as SVR (38.9 ± 7.5 ml/m 2 vs. 52.5 ± 6.1 ml/m 2, p <0.001) and CI (2.6 ± 0.5 l/[min·m 2] vs. 3.7 ± 0.4 l/[min·m 2], p <0.001). Systemic vascular resistance was higher in SHT (12.5 ± 2.5 mm Hg·min/ [l·m 2] vs. 8.6 ± 1.1 mm Hg·min/[l·m 2], p = 0.003). The E1 was higher in controls than in SHT at the basal (p = 0.007), equatorial (p = 0.05), and apical (p = 0.008) levels, as well as E2 at the equatorial (p = 0.001) and apical (p = 0.001) levels. All parameters normalized after replacement therapy. A negative correlation between TSH and EDV (p <0.001), SV (p <0.001), CI (p <0.001), and E1 at the apical level (p <0.001) and a positive correlation between TSH and SVR (p <0.001) and E2 at the apical level (p <0.001) were found. Subclinical hypothyroidism significantly decreased cardiac preload, whereas it increased afterload with a consequent reduction in SV and cardiac output. Replacement therapy fully normalized the hemodynamic alterations.

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