Abstract
Background: Hypothyroidism is known to cause reversible cardiac dysfunction in humans. Thyroid hormone alters the cardiovascular hemodynamics. This study was performed to assess echocardiographic changes in untreated newly diagnosed primary hypothyroid states as such studies are scarce in our setting.Methods: This hospital based cross-sectional study was conducted among 71 patients with newly diagnosed primary hypothyroidism who presented to the medicine outpatient department, at Universal College of Medical Sciences and Teaching Hospital (UCMS-TH), Bhairahawa, Nepal from December 2018 to June 2020 after taking ethical clearance from institutional review committee (UCMS/IRC/212/18). Thyroid function test and echocardiography were carried out in patients under study. The data was analyzed with SPSS Version 16.Results: A total of 71 patients (52 females and 19 males) with primary hypothyroidism were enrolled for the study. Among these 58 cases were overt/clinical hypothyroidism, and 13 cases were subclinical hypothyroidism. Echocardiography was abnormal in 63.4% of cases with 43.7% showing diastolic dysfunction, 18.3% diastolic interventricular septal thickness abnormality, 8.5% diastolic left ventricular posterior wall thickness abnormality, and 8.4% pericardial effusion. Conclusion: Our study found diastolic dysfunction, diastolic interventricular septal thickness abnormality, diastolic left ventricular posterior wall thickness abnormality, and pericardial effusion as the common echocardiographic change in patients with newly diagnosed primary hypothyroidism. Therefore, our study highlights the need for cardiac evaluation of patients with primary hypothyroidism so that early intervention can be performed to improve the clinical outcome.
Highlights
Thyroid dysfunction is a common endocrine disorder affecting about 300 million people worldwide with over half estimated to be unaware of their condition.[1]
The results showed that both subclinical and overt hypothyroidism was mostly seen in the age group 36-45 years and was least in the 18-25 years age group
The bivariate logistic regression showed that age group 36-45 were about 1.67 times more likely to have subclinical hypothyroidism as compared to age group 18-25 (OR=1.67, 95% CI=0.1517.89, p=0.67) and age group 35-45 were two times more likely to have overt hypothyroidism as compared to age group 18-25 years (OR=2.0, 95% CI = 0.1039.07, p=0.65)
Summary
Thyroid dysfunction is a common endocrine disorder affecting about 300 million people worldwide with over half estimated to be unaware of their condition.[1]. Hypothyroidism is a clinical syndrome which results in deficiency of thyroid hormone. There is a defect within the thyroid gland and in secondary hypothyroidism, indirect pathologies (disorders of hypothalamus or pituitary gland) contribute to the decrease in circulating hormone levels.[3] Overt hypothyroidism refers to cases in which the serum thyroid stimulating hormone (TSH) concentration is elevated and serum FT4 (free tetraidothyroxine) is below the reference range. Subclinical hypothyroidism is defined as a serum TSH above the defined upper limit of the reference range, with a serum FT4 within the reference range.[4]. Hypothyroidism is known to cause reversible cardiac dysfunction in humans. This study was performed to assess echocardiographic changes in untreated newly diagnosed primary hypothyroid states as such studies are scarce in our setting
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