Euthyroid State in Hashimoto Thyroiditis in Children Seems to Protect Against Subclinical Cardiomyopathy

Abstract

Background: Hashimoto thyroiditis (HT) is associated with myocardial dysfunction, it is attributed to the autoimmune chronic inflammation and other endocrine factors.Aim of the work: Detection of subclinical myocardial dysfunction in children with euthyroid Hashimoto thyroiditis using speckle tracking echocardiography and estimation of carotid intima- media thickness.Patients and Methods: We performed a case-control cross-sectional study that involved 15 children with euthyroid HT following up at the Endocrinology Clinic, Ain Shams University Children’s Hospital from October 2020 to July 2021 and 15 healthy controls of comparable age and sex. Both groups underwent conventional and speckle tracking echocardiography in addition to estimation of carotid intima-media thickness by high resolution ultrasound machine.Results: The children with euthyroid HT had a mean ± SD age of 13.20 ± 3.05 years, while that of the control group was 11.80 ± 3.03 years (p=0.21). Twelve (80%) of the children with HT and 11(73%) of the control group were females (p=0.66). The mean ± SD for serum-free T3, free T4 and thyroid stimulating hormone (TSH) were 3.57 ± 1.07, 1.43 ± 0.76 ng/dl, and 4.03 ± 2.27 IU/ml in patients, and were 3.59±9.21 pg/ml, 1.29±0.15 ng/dl and 3.4 ±0.3 IU/ml in control group (p = 0.474), (p=0.249) and (p=0.316) respectively. The mean (range) left ventricular global longitudinal strain of the cases and control group were within the normal range (-20.44± 1.24) (- 23 to -17.4) and (-20.94± 0.59) (-21.8 to -19.5) respectively) (p= 0.159). The mean carotid intima- media thickness was normal in both cases (0.35 ±0.05 cm) and controls (0.33 ±0.05 cm) (p = 0.47).Conclusion: Euthyroid state seems to protect against subclinical myocardial dysfunction in Hashimoto thyroiditis.