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Subklinik Hipotiroidili Çocuklarda Levotiroksinin Kardiyak Fonksiyonlar Üzerine Etkilerinin Değerlendirilmesi

Year 2020, Volume: 6 Issue: 2, 192 - 196, 01.01.2020

Abstract

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

References

  • Peeters RP. Subclinical hypothyroidism. N Engl J Med 2017; 376(26):2556-65.
  • Kaplowitz PB. Subclinical hypothyroidism in children: Normal variation or sign of a failing thyroid gland? Int J Pediatr Endocrinol 2010; 2010:281453.
  • Salerno M, Capalbo D, Cerbone M, De Luca F. Subclinical hypothyroidism in childhood - current knowledge and open issues. Nat Rev Endocrinol 2016; 12(12):734-46. 4. McDermott MT, Ridgway hypothyroidism is mild thyroid failure and should be treated. J Clin Endocrinol Metab 2001; 86(10):4585-90.
  • Bundak R, Furman A, Gunoz H, Darendeliler F, Bas F, Neyzi O. Body mass index references for Turkish children. Acta Pediatr 2006; 95(2):194-8.
  • Hermanussen M. Auxology: An update. Horm Res Pediatr 2010; 74(3):153-64.
  • Aghini-Lombardini F, Di Bello V, Talini E, Di Cori A, Monzani F, Antonangeli L, Palagi C, Caraccio N, Delle Donne MG, Nardi C, Dardano A, Balbarini A, Mariani M, Pinchera A. Early textural and functional alterations of left ventricular myocardium in mild hypothyroidism. European Journal of Endocrinology 2006; 155:3-9.
  • Arem R, Rokey R, Kiefe C. Cardiac systolic and diastolic function at rest and exercise in subclinical hypothyroidism effect of thyroid hormone therapy. Thyroid 1996; 6:397- 402.
  • Öner FA, Yurdakul S, Öner E, Arslantaş MK, Usta M, Ergüney M. Evaluation of ventricular functions using tissue Doppler echocardiography in patients with subclinical hypothyroidism. Arch Turk Soc Cardiol 2011; 39(2):129-36.
  • Biondi B, Fazio S, Palmieri EA. Left ventricular diastolic dysfunction in patients with subclinical hypothyroidism. J Clin Endocrinol Metab 1999; 84:2064-7.
  • Monzani F, Di Bello V, Caraccio N. Effect of levothyroxine on cardiac function and structure in subclinical hypothyroidism: A double blind, placebo- controlled study. J Clin Endocrinol Metab 2001; 86:1110- 5.
  • Mariotti S, Zoncu S, Pigiaru F, Putzu C, Cambuli V.M, Vargiu S, Deidda M, Mercuro G. Cardiac effects of L-thyroxine administration in borderline hypothyroidism. Int J Cardiol 2008; 126(2):190-5. (Epub 2007 May 11).
  • Çatli G, Kir M, Anik A, Yilmaz N, Böber E, Abaci A. The effect of L-thyroxine treatment on left ventricular functions in children with subclinical hypothyroidism. Arch Dis Child 2015; 100(2):130-7.

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

Year 2020, Volume: 6 Issue: 2, 192 - 196, 01.01.2020

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

References

  • Peeters RP. Subclinical hypothyroidism. N Engl J Med 2017; 376(26):2556-65.
  • Kaplowitz PB. Subclinical hypothyroidism in children: Normal variation or sign of a failing thyroid gland? Int J Pediatr Endocrinol 2010; 2010:281453.
  • Salerno M, Capalbo D, Cerbone M, De Luca F. Subclinical hypothyroidism in childhood - current knowledge and open issues. Nat Rev Endocrinol 2016; 12(12):734-46. 4. McDermott MT, Ridgway hypothyroidism is mild thyroid failure and should be treated. J Clin Endocrinol Metab 2001; 86(10):4585-90.
  • Bundak R, Furman A, Gunoz H, Darendeliler F, Bas F, Neyzi O. Body mass index references for Turkish children. Acta Pediatr 2006; 95(2):194-8.
  • Hermanussen M. Auxology: An update. Horm Res Pediatr 2010; 74(3):153-64.
  • Aghini-Lombardini F, Di Bello V, Talini E, Di Cori A, Monzani F, Antonangeli L, Palagi C, Caraccio N, Delle Donne MG, Nardi C, Dardano A, Balbarini A, Mariani M, Pinchera A. Early textural and functional alterations of left ventricular myocardium in mild hypothyroidism. European Journal of Endocrinology 2006; 155:3-9.
  • Arem R, Rokey R, Kiefe C. Cardiac systolic and diastolic function at rest and exercise in subclinical hypothyroidism effect of thyroid hormone therapy. Thyroid 1996; 6:397- 402.
  • Öner FA, Yurdakul S, Öner E, Arslantaş MK, Usta M, Ergüney M. Evaluation of ventricular functions using tissue Doppler echocardiography in patients with subclinical hypothyroidism. Arch Turk Soc Cardiol 2011; 39(2):129-36.
  • Biondi B, Fazio S, Palmieri EA. Left ventricular diastolic dysfunction in patients with subclinical hypothyroidism. J Clin Endocrinol Metab 1999; 84:2064-7.
  • Monzani F, Di Bello V, Caraccio N. Effect of levothyroxine on cardiac function and structure in subclinical hypothyroidism: A double blind, placebo- controlled study. J Clin Endocrinol Metab 2001; 86:1110- 5.
  • Mariotti S, Zoncu S, Pigiaru F, Putzu C, Cambuli V.M, Vargiu S, Deidda M, Mercuro G. Cardiac effects of L-thyroxine administration in borderline hypothyroidism. Int J Cardiol 2008; 126(2):190-5. (Epub 2007 May 11).
  • Çatli G, Kir M, Anik A, Yilmaz N, Böber E, Abaci A. The effect of L-thyroxine treatment on left ventricular functions in children with subclinical hypothyroidism. Arch Dis Child 2015; 100(2):130-7.
There are 12 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Hikmet Dağçoban This is me

Diyar Tamburacı Uslu This is me

Gamze Çelmeli This is me

Gayaz Akçurin This is me

Sema Akçurin This is me

Publication Date January 1, 2020
Published in Issue Year 2020 Volume: 6 Issue: 2

Cite

Vancouver Dağçoban H, Tamburacı Uslu D, Çelmeli G, Akçurin G, Akçurin S. Subklinik Hipotiroidili Çocuklarda Levotiroksinin Kardiyak Fonksiyonlar Üzerine Etkilerinin Değerlendirilmesi. Akd Med J. 2020;6(2):192-6.