In:
Circulation: Cardiovascular Imaging, Ovid Technologies (Wolters Kluwer Health), Vol. 14, No. 11 ( 2021-11)
Kurzfassung:
Hypothyroidism is reportedly associated with increased cardiovascular risk and heart failure. We aimed to elucidate the mechanistic influence of atrio-ventricular deformations and their prognostic utilizations in asymptomatic subclinical hypothyroidism (SCH). Methods: We assessed speckle-tracking of deformations among 4173 population-based asymptomatic individuals classified as euthyroid (0.25 〈 thyroid-stimulating hormone [TSH] ≤4.0 μIU/mL, n=3799) or having mild (4 〈 TSH ≤10.0 μIU/mL, n=349) or marked (TSH 〉 10 μIU/mL, n=25) SCH. We further related deformational indices to outcomes of atrial fibrillation and heart failure. Results: Despite borderline differences in indexed left ventricular mass and left atrial volume ( P =0.054 and 0.051), those classified as mild and marked SCH presented with modest but significant reductions of global longitudinal strain, and showed elevated E/tissue Doppler imaging (TDI)-e′, markedly diminished peak atrial longitudinal strain and higher left atrial stiffness (all P 〈 0.05) when compared with euthyroid subjects. A higher TSH level was independently associated with reduced TDI-s′/TDI-e′, worse global atrio-ventricular strains (global longitudinal strain/peak atrial longitudinal strain), elevated E/TDI-e′, and worsened left atrial strain rate components (all P 〈 0.05). Over a median 5.6 years (interquartile range, 4.7–6.5 years) follow-up, myocardial deformations yielded independent risk prediction using Cox regression in models adjusted for baseline covariates, N-terminal pro-brain natriuretic peptide, E/e′, and treatment effect. Incorporation of global atrio-ventricular strain (global longitudinal strain/peak atrial longitudinal strain) and strain rates further showed improved risk reclassification when added to the baseline TSH strata (classified as euthyroid and mild and marked SCH; all P 〈 0.05). Cox regression models remained significant with improved risk reclassification beyond TSH-based strata by using slightly different deformational cutoffs after excluding marked SCH group. Conclusions: Hypothyroidism, even when asymptomatic, may widely influence subclinical atrio-ventricular mechanical functions that may lead to higher heart failure and atrial fibrillation risk. We proposed the potential usefulness and prognostic utilization of myocardial strains in such population.
Materialart:
Online-Ressource
ISSN:
1941-9651
,
1942-0080
DOI:
10.1161/CIRCIMAGING.121.012433
Sprache:
Englisch
Verlag:
Ovid Technologies (Wolters Kluwer Health)
Publikationsdatum:
2021
ZDB Id:
2440475-5
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