The Role of Myocardial Performance Index in Evaluating Effect of Hypothyroidism on Systolic and Diastolic Functions of Heart

Year 2023, Volume: 3 Issue: 4, 87 - 90, 09.10.2023

Murat Kahramaner , Erdal Belen , Edip Erkuş , Şerife Ayşen Helvacı

https://doi.org/10.5152/Pharmata.2023.23023

Abstract

Objective: Hypothyroidism causes pathological changes in the heart. Systolic and diastolic functions
of the left ventricle of the heart can be evaluated with the myocardial performance index
(MPI). We compared MPI in overt hypothyroidism patients vs. healthy group.
Methods: The study included 50 healthy control subjects and 50 overt hypothyroid patients.
Echocardiographic procedure was performed in all patients. The following parameters, like ejection
fraction (EF), diastolic transmitral peak velocity (E and A waves), E/A ratio, and MPI, were
measured.
Results: The E wave (0.79 ± 0.26 m/s) and E/A ratio (0.95 ± 0.30), which are echocardiographic
parameters that reflect cardiac diastolic dysfunction, were dramatically lower in the case group
(P < .05). Myocardial performance index (MPI) (0.42 ± 0.04), which reflects systolic and diastolic
functions of the heart, was significantly higher in the case group (P < .05). Ejection fraction value
(62.5 ± 4.0%) was not statistically different between the case and healthy subjects (P > .05).
Conclusion: Significant decrease in E and E/A values in the hypothyroid patients indicated the
development of diastolic dysfunction. Although no difference could be detected between the
groups in EF value, which reflects systolic functions of the heart, a significant increase in MPI
value in the hypothyroid group indicated that systolic and diastolic functions of the heart started
to deteriorate. In our study, the elevation of the MPI in hypothyroid patients without EF impairment
suggests that MPI should be practiced more widely in the evaluation of cardiac functions in
hypothyroid patients.

Keywords

Diastolic dysfunction, hypothyroidism, myocardial performance index, systolic dysfunction

Ethical Statement

Ethics committee approval was received for this study from the ethics committee of Prof. Dr. Cemil Taşçıoğlu University (Number: E-486 70771 -903. 99-21 90425 63).

The Role of Myocardial Performance Index in Evaluating Effect of Hypothyroidism on Systolic and Diastolic Functions of Heart

Abstract

Objective: Hypothyroidism causes pathological changes in the heart. Systolic and diastolic functions of the left ventricle of the heart can be evaluated with the myocardial performance index (MPI). We compared MPI in overt hypothyroidism patients vs. healthy group.

Methods: The study included 50 healthy control subjects and 50 overt hypothyroid patients. Echocardiographic procedure was performed in all patients. The following parameters, like ejection fraction (EF), diastolic transmitral peak velocity (E and A waves), E/A ratio, and MPI, were measured.

Results: The E wave (0.79 ± 0.26 m/s) and E/A ratio (0.95 ± 0.30), which are echocardiographic parameters that reflect cardiac diastolic dysfunction, were dramatically lower in the case group (P < .05). Myocardial performance index (MPI) (0.42 ± 0.04), which reflects systolic and diastolic functions of the heart, was significantly higher in the case group (P < .05). Ejection fraction value (62.5 ± 4.0%) was not statistically different between the case and healthy subjects (P > .05).

Conclusion: Significant decrease in E and E/A values in the hypothyroid patients indicated the development of diastolic dysfunction. Although no difference could be detected between the groups in EF value, which reflects systolic functions of the heart, a significant increase in MPI value in the hypothyroid group indicated that systolic and diastolic functions of the heart started to deteriorate. In our study, the elevation of the MPI in hypothyroid patients without EF impairment suggests that MPI should be practiced more widely in the evaluation of cardiac functions in hypothyroid patients.

Keywords

Diastolic dysfunction, hypothyroidism, myocardial performance index, systolic dysfunction

Ethical Statement

Ethics committee approval was received for this study from the ethics committee of Prof. Dr. Cemil Taşçıoğlu University (Number: E-486 70771 -903. 99-21 90425 63).

References

• 1. Chaker L, Bianco AC, Jonklaas J, Peeters RP. Hypothyroidism. Lancet. 2017;390(10101):1550-1562.
• 2. Chaker L, Razvi S, Bensenor IM, Azizi F, Pearce EN, Peeters RP. Hypothyroidism published correction appears in Nat. Rev Primers. 2022;8(1):39.
• 3. Udovcic M, Pena RH, Patham B, Tabatabai L, Kansara A. Hypotyroidism and the heart. Methodist Debakey CardioVasc J. 2017;13(2):55- 59.
• 4. Klein I, Ojamaa K. Thyroid hormone and the cardiovascular system. N Engl J Med. 2001;344(7):501-509.
• 5. Pearce EN, Yang Q, Benjamin EJ, Aragam J, Vasan RS. Thyroid function and left ventricular stracture and function in the Framingham Heart Study. Thyroid. 2010;20(4):369-373.
• 6. Klein I. Endocrine disorders and cardiovascular disease. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine, 8th. Saunders Elsevier, Philadelphia; 2008:2033.
• 7. Tei C, Ling LH, Hodge DO, et al. New index of combined systolic and diastolic myodarcial performance: a simple and reproducible measure of cardiac functions study in normals and dilated cardiomyopathy. J Cardiol. 1995;26(6):357-366.
• 8. Goroshi M, Chand D. Myocardial Performance Index (Tei Index): A simple tool to identify cardiac dysfunction in patients with diabetes mellitus. Indian Heart J. 2016;68(1):83-87.
• 9. Faber J, Selmer C. Cardiovascular disease and thyroid function. Front Horm Res. 2014;43:45-56.
• 10. Danzi S, Klein I. Posttranscriptional regulation of myosin heavy chain expression in heart by triiodothyronine. Am J Physiol Heart Circ Physiol. 2005;288(2):H455-H460.
• 11. Taddei S, Caraccio N, Virdis A, et al. Impaired endothelium-dependent vasodilatation in subclinical hypothyroidism: benefical effect of levothyroxine therapy. J Clin Endocrinol Metab. 2003;88(8):3731- 3737.
• 12. Fraczek MM, Łacka K. Thyroid hormone and the cardiovascular system. Pol Merkur Lekarski. 2014;37(219):170-174.
• 13. Vargas-Uricoechea H, Bonelo-Perdomo A, Sierra-Torres CH. Effects of thyroid hormones on the heart. Clin Investig Arterioscler. 2014;26(6):296-309.
• 14. Klein I, Danzi S. Throid disease and the heart. Circulation. 2007;116(15):1725-1735.
• 15. Chawda N, Jain S, Solanki B, et al. A study of cardiovascular manifestations in hypothyroidism. Series Endo Diab Met. 2022;4(3):68-77.
• 16. Erdogan E, Akkaya M, Bacaksız A, et al. Electrocardiographic and echocardioographic evidence of myocardial impairment in patients with overt hypothyroidism. Ann Endocrinol (Paris). 2013;74(5-6):477- 482. Epub 2013 Nov 20.
• 17. Karabag T, Dogan SM, Bayraktaroğlu T, et al. Assessment of left atrial mechanical functions in thyroid dysfunction. Pol Arch Med Wewn. 2013;123(11):596-602.
• 18. Galderisi M, Vitale G, D’Errico A, et al. Usefulness of pulsed tissue Doppler for the assessment of left ventricular myocardial functionin overt hypothyroidism. Ital Heart J. 2004;5(4):257-264.
• 19. Ambakederemo TE,Ychenna DI, Ogumola JO. Usefulness of Tai index in Patients with Heart Failure. Internet J Intern Med. 2009;9(1):1-8.
• 20. Doin FL, Borges R, Campos O, et al. Effect of centralhypotthyroidism on Doppler derived myocardial performance index. J Am Soc Echocardiogr. 2004;17(6):622-629.