Diastolic dysfunction in subclinical hypothyroid patients in rural India: A case–control study

Nag, Chiranjib; Seth, Bikash C; Haldar, S.K.

doi:10.4103/0189-7969.173855

Cited by 5 publications

(10 citation statements)

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“…The SCH group had lower FT4 levels compared with that of the controls but within the normal range and is comparable to other studies. 10 11 13 17 In this study, the mean T3 value in the case arm of the study was 1.23 ± 0.29 ng/dL and in the control arm of the study was 1.36 ± 0.36 ng/dL. The T3 levels were lower in the cases than that in the controls but both were well within the normal range and are similar to other studies.…”

Section: Discussionsupporting

confidence: 88%

“…Most other studies have also reported a female preponderance, with females accounting for at least 75% of the study population. 10 11 13 The reason for female preponderance is still unclear but estrogen has been implicated in a study done on postmenopausal women by Arafah, 14 which showed hormone replacement therapy increased TSH. In the Whickham survey, 9 elder women above the age of 45 years showed a higher prevalence of SCH.…”

Section: Discussionmentioning

confidence: 99%

“…The T3 levels were lower in the cases than that in the controls but both were well within the normal range and are similar to other studies. 10 13…”

Section: Discussionmentioning

confidence: 99%

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Left Ventricular Diastolic Dysfunction in Patients with Subclinical Hypothyroidism: A Single South Indian Tertiary Care Centre Study

Kuchulakanti

Sharma

Utagi

2023

Journal of Health and Allied Sciences NU

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Context Subclinical hypothyroidism (SCH) has been implicated in left ventricular diastolic dysfunction (LVDD). Aims To study the association between SCH and LVDD. Objectives To analyze the association between SCH and LVDD. To correlate the amount of LVDD with the serum thyroid-stimulating hormone (TSH) levels. Settings and Design Single-center case–control study. Methods and Material A case–control study was conducted between January 2020 and June 2021. A total of 36 cases of SCH were enrolled in the study and 36 age- and gender-matched euthyroid controls were included. Each individual's LV diastolic functioning was assessed by 2D echocardiography. LVDD was graded and compared between cases and controls. Statistical Analysis Used The sample size was calculated to be 72 based on previous studies. Statistical analysis was performed using the IBM SPSS software version 20. A p-value of less than 0.05 was considered significant. Results SCH was more commonly seen among females (75%) as compared with males (25%). Among cases, a majority of them (75%) had grade 1 SCH (i.e., TSH < 10 mU/L) and 25% of them had grade 2 SCH (i.e., TSH ≥ 10 mU/L). Among all the parameters assessed for LV diastolic function, the isovolumetric relaxation time and septal E/e' ratio was found to be significantly higher in cases than in controls and mitral E wave deceleration time (DT) significantly lower in cases. A statistically significant majority (72.2%) of the patients with SCH had some form of LVDD as compared with controls (30.5%) Conclusions Walk-in outpatient department patients who opt for health check-up packages should be screened for SCH. SCH is statistically significantly associated with higher grades of LVDD as compared with age- and gender-matched euthyroid controls.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

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Left Ventricular Diastolic Dysfunction in Patients with Subclinical Hypothyroidism: A Single South Indian Tertiary Care Centre Study

Kuchulakanti

Sharma

Utagi

2023

Journal of Health and Allied Sciences NU

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“…Signifi cant correlation is found between TSH level and diastolic dysfunction [35].Th e present study also agree with that of Nag et al, which conclude that there was signifi cant left ventricular diastolic dysfunction as measured by increased mitral peak A velocity (P < 0.001), decreased E/A ratio (P < 0.001), prolonged isovolumetric relaxation time (P = 0.035). While left ventricular systolic function was similar in both groups with no signifi cant change [36].…”

Section: Discussionmentioning

confidence: 81%

Paraoxinase-1 Activity in Patients with Subclinical Hypothyroidism: A link to Atherosclerosis

Elkafrawy¹

2020

RIJED

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Objective: To investigate paraoxinase-1 (PON-1) activity in subclinical hypothyroidism (SCH) patients in comparison with acute coronary syndrome (ACS) patients and to determine the prevalence of SCH among patients with ACS. Background: Paraoxonase1 (PON1) is an antioxidant enzyme that plays an important role in lipoprotein metabolism; it is an indicator of the risk of atherosclerosis and coronary artery disease development. Thyroid hormones are associated with both the oxidant-antioxidant balance and lipoprotein metabolism; SCH and its correlation with the atherosclerotic cardiovascular diseases is a subject of debate. Subjects and Methods: This study included 95 subjects from Menou ia University Hospital after exclusion of all known cardiovascular risk factors, classi ied into :Group I (control group) (n=15); Group II (ACS subjects) (n=46), Group III (SCH subject) (n=20) and Group IV (subjects with both ACS and SCH) (n=14).Thorough history taking; complete physical examination, thyroid function tests, lipid pro ile, PON-1 activity, electrocardiogram (ECG) and echocardiographic examination of the heart were done. Results: PON-1 activity was highly signi icant lower in group II and IV than group III than control; there are a signi icant negative correlation between PON-1 activity and thyroid stimulating hormone and a highly signi icant positive correlation with FT4.In addition the severity of dyslipidemia and the prevalence of diastolic dysfunction in group III were comparable to that in group II and the prevalence of SCH among ACS patients is 23.3%. Conclusion: This study suggests that SCH is an independent risk factor for ACS, and the prevalence of SCH among patient with ACS was 23.3%.

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“…In recent studies exploring the role of SCHS in HF subjects, much emphasis has been placed on TTE data to reveal its utilization in the HFpEF cohort. 4 , 22 , 23 Kinugasa and Yamamoto described the specific pattern of HF progression in the SCHS population which included ventricular filling and stiffness restriction. 23 In the real world, this pathophysiology resembles evolutionary mechanisms of HFpEF, indicating an association of HFpEF with SCHS.…”

Section: Discussionmentioning

confidence: 99%

The subclinical hypothyroid state might predict 30-day readmission in patients admitted with acute heart failure syndrome and reduced left ventricular ejection fraction

Saad

Lacoste

Balar

et al. 2020

Therapeutic Advances in Cardiovascular Disease

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Introduction: Thyroid hormone (TH) has an essential role on the functional capability of cardiac muscle with its gene modulation and induction of vasodilatory effects. There is considerable evidence to suggest the role of TH in patients with acute coronary syndrome, but less is known about its prognostic role in heart failure (HF) patients. We aim to evaluate the association between subclinical hypothyroid state (SCHS) and event rates including 30-day all-cause and HF readmission in patients with an index hospitalization for acute HF syndrome (AHFS). Methodology: A retrospective chart review analysis of 2335 patients admitted with the diagnosis of AHFS between 1 January 2007 and 31 December 2017 was conducted. SCHS was defined as thyroid-stimulating hormone (TSH) level >4.50 mIU/L with a normal thyroxine (T4) level. Patients with pre-existing thyroid disease or receiving thyroid replacement therapy were excluded. HF with preserved ejection fraction (HFpEF) was defined as left ventricular ejection fraction (LVEF) >40% and HF with reduced ejection fraction (HFrEF) was defined as having LVEF ⩽40%. Percentage of 30-day, 3-month and 6-month all-cause readmission and mortality rates were calculated in both cohorts of AHFS (HFpEF and HFrEF) with and without SCHS. Results: The mean age of the 2335 AHFS population was 65 (±14.8) years. Of the 2335 patients admitted with AHFS, 1228 (52.6%) patients were found to have HFrEF and 1107 (47.4%) with HFpEF. There were 170 (7.3%) patients with AHFS found to have SCHS. There were more males than females (54% versus 46%). The percentage of hospital readmission within 30 days was higher for patients with SCHS compared with those without SCHS in the HFrEF group (42% versus 30%, p = 0.001). Hospital readmission within 30 days for patients with SCHS compared with those without SCHS in the HFpEF group did not differ (36.5% versus 31%, p = 0.47). Additionally, all-cause mortality was higher among patients with SCHS compared with patients without SCHS in the HFrEF group (18.7% versus 7.0%, p < 0.001). All-cause mortality was found similar in both arms of the HFpEF group (9.5% versus 7.7%, p = 0.73). Conclusion: During an index hospital admission for AHFS, SCHS was an independent predictor of readmission in 30 days in patients with HFrEF but not in patients with HFpEF. Additionally, it was related to adverse outcome such as all-cause mortality in HFrEF patients but not in HFpEF patients. Further studies regarding the concept of tissue thyroid and the potential for a therapeutic target are warranted.

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Diastolic dysfunction in subclinical hypothyroid patients in rural India: A case–control study

Cited by 5 publications

References 0 publications

Left Ventricular Diastolic Dysfunction in Patients with Subclinical Hypothyroidism: A Single South Indian Tertiary Care Centre Study

Left Ventricular Diastolic Dysfunction in Patients with Subclinical Hypothyroidism: A Single South Indian Tertiary Care Centre Study

Paraoxinase-1 Activity in Patients with Subclinical Hypothyroidism: A link to Atherosclerosis

The subclinical hypothyroid state might predict 30-day readmission in patients admitted with acute heart failure syndrome and reduced left ventricular ejection fraction

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