Subklinik Hipotiroidili Çocuklarda Levotiroksinin Kardiyak Fonksiyonlar Üzerine Etkilerinin Değerlendirilmesi

Öz

Amaç: Subklinik hipotiroidili çocuklarda kardiyak fonksiyonları değerlendirmek ve levotiroksin tedavisinin bu işlevler üzerindeki etkisini araştırmak.Gereç ve Yöntemler: Ortalama kronolojik yaşı 7,41 yaş olan, subklinik hipotiroidili 16 prepubertal olguyu içeren çalışma grubunun tiroid fonksiyon testleri serbest triiyodotironin, serbest tiroksin, tiroid stimülan hormon , ekokardiyografik parametreleri kardiyak sistolik fonksiyonlar, kardiyak diyastolik fonksiyonlar ve kardiyak doku Doppler göstergeleri çalışmanın başlangıcında değerlendirilmiştir. Olgulara ötiroidizmi sağlayacak şekilde 1-3 µg/kg/gün dozunda levotiroksin tedavisi başlanmıştır. Tedavi başlangıcındaki değerler tedavinin üçüncü ve altıncı aylarında elde edilen parametreler ile karşılaştırılmıştır.Bulgular: Üç ve altı aylık tedavi periyodunun sonunda sırasıyla 16 ve dokuz olguda, tiroid stimülan hormon düzeyleri anlamlı olarak azalırken, serbest triiyodotironin ve serbest tiroksin düzeylerinde anlamlı fark bulunmamıştır. Tedavinin üçüncü ayında, tedavi öncesi değere göre mitral E dalgasının A dalgasına oranında anlamlı bir artış saptanmıştır p

Anahtar Kelimeler

• Levotiroksin, Kardiyak fonksiyonlar, Subklinik hipotiroidizm, Çocuklar

Assessment of the Effects of Levothyroxine on Cardiac Functions in Children with Subclinical Hypothyroidism

Abstract

Objective: To assess cardiac functions in children with subclinical hypothyroidism and investigate the effect of levothyroxine treatment on these functions.Material and Methods: Thyroid function tests free triiodothyronine, free thyroxine, thyroid stimulating hormone , echocardiographic parameters cardiac systolic functions, cardiac diastolic functions and cardiac tissue Doppler indicators of the study group, which consist of 16 prepubertal cases at an average chronological age of 7.41 years, were evaluated at the beginning of the study. Levothyroxine treatment was started at 1-3 µg/kg/day to provide euthyroidism to the patients. The values at the beginning of treatment were compared with the parameters obtained at the third and sixth months of treatment.Results: Thyroid stimulating hormone levels were found to be significantly decreased at the end of three- and six- month treatment period in 16 and nine cases, respectively, whereas there was no significant difference in free triiodothyronine and free thyroxine levels. In the third month of treatment, there was a significant increase in the ratio of mitral E wave to A wave compared to the pretreatment value p

Keywords

• Levothyroxine, Cardiac functions, Subclinical hypothyroidism, Children

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