BACKGROUND:
Hypothyroidism is associated with various cardiovascular derangements. Clinically diagnosed and reported cases are countable only like the “Tip of the Iceberg” in our modernized world. Pathological changes in the heart if detected at earlier stages are reversible with timely and regular levothyroxine therapy. Coronary artery disease, stroke, and multiorgan failure especially due to renal, hepatic, and other system involvement are commonly encountered medical entities as direct or indirect involvement of the cardiovascular system in cases of hypothyroidism.
AIM:
Cardiovascular complications are one of the leading causes of death in hypothyroidism. Research studies done in various parts of world and also in India suggest the significant association between cardiovascular system involvement and hypothyroidism. Early diagnostic modalities like Echocardiography can easily detect these changes and can prevent morbidity and mortality in these patients. Hence our study was carried out to see whether significant association exists between various 2D Echo parameters in hypothyroid, control and those taking treatment with levothyroxine and to find out and suggest any preventive measures for the same.
METHODS:
Cross-sectional case-control study was carried out on 90 adults (Males & Females) of age group more than 30 years. Cases were divided into three equal groups of 30 subjects (28 female and 2 males) each belonging to the same socio-economic status. Group I consisted of Euthyroid subjects, Group II of newly diagnosed and untreated hypothyroid patients and Group III was of hypothyroid patients taking synthetic thyroid hormone for more than 5 years. Individual with diabetes, hypertension, cardiovascular, pulmonary, renal or liver diseases, pregnancy and endocrine disorders other than hypothyroidism were strictly excluded. Study was approved by Institutional and University ethical committee and written informed consent was taken from all subjects enrolled in this study protocol of tertiary care center and medical college in metro city located in the center of country. Statistically significant variation in three Groups determined by one-way ANNOVA test and multiple comparisons between Group I vs. Group II, Group I vs. Group III, and Group II vs. Group III was done by Tukey test.
RESULTS:
Mean value of Left Ventricular Ejection fraction (EF) was found significantly reduced in Group II as compared to Group I. No significant difference was found in Group I and Group III. Significantly increased value was found in Group III as compared to Group II. It was observed that in group II the value of Interventricular septum thickness (IVST) and Posterior wall thickness (PWT) were increased as compared with Group I. No statistically significant difference was noted in Group I and Group III. Significantly decreased values of both were observed in Group III as in comparison with Group II. It was found that Isovolumic relaxation time (IVRT) and deceleration time (DT) were significantly prolonged in Group II and higher values were observed as compared to Group I. Non-significant deference was found for the same parameters in Group I and Group III. Group III showed significant lower values of these parameters as compared to Group II. Significantly low value of early peak mitral inflow velocity (E) during diastole found in group II as in comparison with Group I. No statistically significant difference was found in Group I and Group III and also in Group III and Group II. Significantly high value of late peak mitral inflow velocity (A) during diastole found in Group II as in comparison with Group I. No statistically significant difference was found in Group I and Group III. Significantly decrease in the value during diastole was observed in Group III as compared to Group II. Value of Early / Late peak mitral inflow velocity during diastole (E/A) ratio was found significantly low in group II as in c
Key words: ANNOVA test, Tukey test, Ejection fraction, Echocardiography, Hypothyroidism
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