Comparing cardiac asymmetric septal hypertrophy in hypothyroid patients before and after Levothyroxine therapy

Abstract

Asymmetrical septal hypertrophy (ASH)is the echocardiographic manifestationof hypertrophic cardiomyopathy(HCM). HCM is characterized by inappropriate left ventriclehypertrophy with preferential involvement of theinterventricular symptom causing increased ventricularstiffness, which in turn results in diastolic dysfunction anddynamic left ventricular outflow tract pressure gradient.The study population included 65 newly diagnosed clinicalhypothyroidism patients (52 female and 13 male with themean age: 36.7±11.5), who were referred to endocrinologyclinic of Shiraz University of Medical Sciences, Shiraz,Iran. All analyses were performed using SPSS for the window,version 15.0. Continuous variables are presented asmean±SD, while categorical variables are presented as percentage.The prevalence of ASH (IP ratio ≥1.3) was 20%(13 in 65 patients), which was statistically very significant(in relation to 0.2% seen in the total population). In thepresent study, we investigated the prevalence of ASH inclinical hypothyroidism and also myocardial systolic anddiastolic parameter in these patients before and after thetreatment. It is conceivable that hypothyroidism is associatedwith both global LV dysfunction and localized septalmyocardial abnormality. Since the clinical significance ofthis reversible cardiomyopathy is unclear, routine echocardiogramsare not indicated in hypothyroidism. However,any patient with hypothyroidism with symptoms of cardiovasculardysfunction (such as dyspnea, dizziness syncope,pericardial pain resembling angina pectoris) should undergothe echocardiographic examination to exclude HCM.