Does Diastolic Dysfunction Cause Exertional Dyspnea in Newly Diagnosed
Hyperthyroid Patients with Preserved Left Ventricular Systolic Function?
Abstract
Abstract Background: diastolic dysfunction has been reported as a
cardiovascular effect of hyperthyroidism, and is also supposed to be a
cause of heart failure manifestations in the patients with preserved
ejection fraction (EF). Methods: for evaluation of diastolic function in
hyperthyroid patients and also diastolic Function during performing
exercise stress echocardiography, we conducted this study on 26 newly
diagnosed hyperthyroid patients compared to 26 healthy subjects as
control group. Diastolic function of the patients at rest was assessed
using these parameters as follows: left atrium volume index, tricuspid
regurgitation (TR) velocity, mitral inflow early diastolic flow (E
wave), tissue doppler of mitral annular velocity (e’), E/e’ ratio, and
isovolumic relaxation time (IVRT); and during exercise stress
echocardiography, we judged diastolic response by measuring E/e’ ratio
and TR velocity at the peak of stress in terms of the American Society
of Echocardiography guideline. Results: the mean age of the patients was
39.77±12.0 years old and 53.8 % of them were female. Cardiovascular
symptoms among the patients were the followings: palpitation (46.2%),
exertional dyspnea (19.2%), and atypical chest pain (7.7%). All the
patients had normal diastolic function at the time of resting and there
was no significant difference in diastolic parameters between the two
groups except for IVRT, which was lower in hyperthyroid patients.
Interestingly, no patients developed diastolic dysfunction during
exercise stress echocardiography. Conclusion: our finding did not
support Hyperthyroidsm associated diastolic dysfunction as a cause of
exertional intolerance and dyspnea in the patients with preserved EF.