Çatli G, Kir M, Anik A, Yilmaz N, Böber E, Abaci A.Arch Dis Child. 2015 Feb;100(2):130-7. doi: 10.1136/archdischild-2014-306381. Epub 2014 Sep 10.
Abstract for The effect of L-thyroxine treatment on left ventricular functions in children with subclinical hypothyroidism
Objective: The aim of this study was to search for evidence suggesting treatment for childhood subclinical hypothyroidism (SH) by evaluating left ventricular (LV) functions of children with SH by using M-mode and tissue Doppler echocardiography (TDE).
Methods: Children with SH and euthyroid healthy children (control group) were enrolled in the study. At baseline and 6 months after euthyroidism was achieved, M-mode and TDE were performed and LV functions were evaluated. Pretreatment parameters of the SH group were compared with those of controls and post-treatment parameters.
Results: 31 children with SH and 32 euthyroid healthy children were enrolled in the study. The groups had similar age, gender, puberty and body mass index. Interventricular septum thickness and LV mass index, which are the parameters for LV morphology, were slightly increased in the SH group than in the controls (p<0.05). In TDE, children with SH had significant changes in LV diastolic (lower E’m, higher E/E’m ratio and longer isovolumic relaxation time) and systolic functions (lower isovolumic contraction time) compared with controls (p<0.05). Six months after euthyroidism was achieved, TDE showed a significant improvement of some of the diastolic and systolic parameters (p<0.05).
Conclusions: The results of this study showed that SH is associated with subclinical alterations in LV function, and LT4 replacement may improve LV systolic and diastolic parameters. However, since SH is usually a self-limiting process, these improvements in LV functions may simply be associated with the natural course of the disease and/or physiological linear growth of the children.
Keywords: Cardiac function; Children; Endocrinology; Subclinical hypothyroidism; tissue Doppler echocardiography.
Uzman Dr. Nuh YILMAZ
Specialist Dr. Nuh Yılmaz, after his medical education at Ege University Faculty of Medicine, he completed his residency in Pediatrics at İzmir Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital. He completed his subspecialty training in Pediatric Cardiology at Dokuz Eylül University Faculty of Medicine. After working as a Pediatric Cardiology Specialist at Liv Hospital Vadi Istanbul Hospital and Istanbul Medical Park Bahçeşehir Hospital, he started accepting patients at İskenderun Gelişim Hospital.