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Changes in cardiac function and structure in newly diagnosed Graves' disease. A conventional and 2D-speckle tracking echocardiography study.

TitleChanges in cardiac function and structure in newly diagnosed Graves' disease. A conventional and 2D-speckle tracking echocardiography study.
Publication TypeJournal Article
Year of Publication2017
AuthorsAroditis, K., Pikilidou M., Vourvouri E., Hadjistavri L., Zebekakis P., Yovos J., Efthimiadis G., & Karvounis H.
JournalInt J Cardiovasc Imaging
Volume33
Issue2
Pagination187-195
Date Published2017 Feb
ISSN1875-8312
KeywordsAdult, Antithyroid Agents, Case-Control Studies, Echocardiography, Doppler, Female, Graves Disease, Humans, Hypertrophy, Left Ventricular, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Recovery of Function, Risk Factors, Time Factors, Treatment Outcome, Ventricular Dysfunction, Left, Ventricular Function, Left
Abstract

Overproduction of thyroid hormones leads to structural as well as functional cardiac changes. Conventional echocardiography but also recently developed sophisticated two-dimensional echocardiography speckle (2D-STE) tracking allow elaborate evaluation of these changes. Our purpose was to investigate the effects of thyroid hormones overproduction on the heart in patients with Graves' disease and changes that occur after 6 months thyrostatic therapy. We conducted a prospective, case-control study of 6 months duration. Full echocardiographic assessment at diagnosis and after 6 months of thyrostatic therapy were performed in 44 patients with Graves' disease, aged 37.6 ± 9.1 years. Additionally, 43 euthyroid controls were studied for the same time period. Left ventricular end diastolic diameter (LVEDD) and left ventricular end systolic diameter (LVESD) were higher in the patient group while triscupid annular plane systolic excursion (TAPSE) was lower in the patient group. Moreover, left ventricular (LV) mass index and left atrium (LA) volume index were higher in the Graves' disease group. Diastolic impairment as assessed with conventional echocardiography including tissue Doppler was present in the patient group (E/A ratio 0.87 ± 0.10,). 2D-STE analysis, revealed an increase in the strain rate at the isovolumic relaxation time (SRIVRT, 0.310 ± 0.07 patients versus 0.298 ± 0.09 s controls). Improvement in diastolic and right systolic function as well as in left ventricular structural parameters was observed after restoration of euthyroidism (E/A ratio from 0.87 ± 0.10 versus 0.9 ± 0.08, p < 0.05). Patients with newly diagnosed Graves' showed an improvement in diastolic function, right systolic function and structural parameters after 6 months of thyrostatic treatment.

DOI10.1007/s10554-016-0984-z
Alternate JournalInt J Cardiovasc Imaging
PubMed ID27680576

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