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

Background: Thyroid dysfunction may affect the heart. Conflicting evidence exists regarding cardiac involvement in subclinical hypothyroid. Objective: Aim of the study is to investigate left ventricular dysfunction in subclinical hypothyroidism. Materials and Methods: This is a case–control study including 51 subclinical hypothyroid patients and 55 age, sex, and body surface area matched control. After meeting inclusion and exclusion criteria, the study population was selected and evaluated with two-dimension, M-mode, and pulse Doppler echocardiography. The following parameters were measured - left ventricular end-diastolic diameter, left ventricular end-systolic diameters, posterior wall thickness, interventricular septal thickness, fractional shortening, left ventricular ejection fraction, left ventricular mass index, diastolic transmitral peak velocity (E and A wave), E/A ratio, deceleration time of mitral E wave, and Tei index. Student's t-test for independent sample with calculation of P value (two-tailed) was applied for statistical analysis using SPSS software (version 17.0). Results: There was significant left ventricular diastolic dysfunction as measured by increased mitral peak A velocity (66.3 ± 8.4 mm/s in case vs. 52.4 ± 4.8 mm/s in control, P < 0.001), decreased E/A ratio (0.90 ± 0.08 in case vs. 1.31 ± 0.36 in control, P < 0.001), prolonged isovolumetric relaxation time (120 ± 13 ms in case vs. 76 ± 9 ms in control, P = 0.035), increased Tei index (0.29 ± 0.13 in case vs. 0.22 ± 0.10 in control, P = 0.015). Left ventricular systolic function as measured by other parameters was similar in both groups with no significant change. Conclusion: Subclinical hypothyroidism is significantly associated with left ventricular diastolic dysfunction.