Background: Subclinical hypothyroidism (SCH) has a prevalence of 4-20%. Although overt hypothyroidism is linked to cardiovascular dysfunctions, there are mixed results when it comes to degree of abnormalities in subclinical hypothyroidism. Since the management remains controversial it would be appropriate to study the cardiovascular abnormalities to initiate timely treatment of patients with mild thyroid failure to prevent cardiac involvement also progression to overt hypothyroidism. The aim of the current study was to assess the cardiovascular abnormalities in subclinical hypothyroidism and evaluate the association between thyroid-stimulating hormone (TSH) and cardiovascular effects among mild and severe subclinical hypothyroidism patients.
Materials and Methods: The observational study was conducted in VIMSAR, Burla, among 210 hospital attendees who were diagnosed with subclinical hypothyroidism selected by consecutive sampling. Cardiovascular profile of these patients were assessed by clinical examination, ECG, lipid profile, hs-CRP, 2D and tissue Doppler echocardiography and compared between mild (TSH<10) and severe (TSH>10) subclinical hypothyroidism using Chi-square and student T-tests.
Results: Doppler-derived indices of left ventricular (LV) diastolic filling showed diastolic dysfunction, as indicated by significant prolongation of the isovolumic relaxation time and significant reduction of the early diastolic mitral flow velocity/late diastolic mitral flow velocity (E/A) ratio. The findings are more significant in patients with TSH>10 (p<0.001). The correlation between TSH and LDL, hs-CRP and anti-TPO antibody was also significant.
Conclusion: Subclinical hypothyroidism is a common condition and affects diastolic function. Although the decision to treat with levothyroxine (LT4) remains controversial, this abnormality may be reversed by levothyroxine substitutive therapy.
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2022: 6.012
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