Echocariographic correlation of cardiac function in patients of hypothyroidism

Abstract

Objective: The aim of the current study was to identify the echocardiographic changes in patients with hypothyroidism and correlation of these echocardiographic changes with the severity of hypothyroidism.

Method: A cross-sectional, and observational study was conducted on 60 treatment naïve patients of 18 to 60 years with hypothyroidism for 15 months from March 2021 to July 2022. The clinical demographic, treatment, ECG and echocardiographic profile were assessed in all patients. The association between categorical findings was determined using the chi-square test. Percentages and frequencies were also used for every parameter.

Results: 36.6% of the patients belonged to the age group 31 to 40 years. The mean age was 37.2±10.67 years and the majority of patients were females (76.67%). 33.3% of patients were overweight. 21.67% were obese and 45% had normal BMI. 21.67% had mild hypothyroidism, 56.67% had subclinical and 8.33% had severe hypothyroidism. There was a significant association between BMI and severity of hypothyroidism (p=0.0167). Abnormal lipid profile was seen in 61.67% of patients and a significant association was observed between total cholesterol and the severity of hypothyroidism (p=0.0031). LVPW thickness was normal in 78.33% of patients. Abnormal interventricular septal thickness was seen in 28.33% of patients. The cardiac chamber was more than 5.4cm in 3.33% of patients. Pericardial effusion was observed in 12 patients. There was a significant association between LVPW thickness, interseptal thickness, cardiac chamber size, ejection fraction, E/A ratio, and severity of hypothyroidism.

Conclusion: Increased interventricular septal and left ventricular posterior wall thicknesses with diastolic dysfunction are one of the earliest heart changes noted in patients with hypothyroidism. Early diagnosis in patients with hypothyroidism will definitely reduce the extent of cardiac complications that accompany it. ECG and echocardiography are useful noninvasive tools in assessing the response to thyroid replacement therapy. The study suggests screening of all patients with hypothyroidism using electrocardiography and ECG as most of the patients show impairment in cardiac functions, so that appropriate intervention can be taken earlier.