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J Cardiol. 2013 Jan;61(1):8-15. doi: 10.1016/j.jjcc.2012.08.017. Epub 2012 Oct 18.

Evaluation of left ventricular diastolic function using tissue Doppler echocardiography and conventional doppler echocardiography in patients with subclinical hypothyroidism aged <60 years: a meta-analysis.

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Department of Clinical Epidemiology, Institute of Cardiovascular Diseases, and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China.


Studies have suggested that subclinical hypothyroidism (SCH) may have detrimental effects on left ventricular (LV) diastolic function. Whether SCH is a risk factor for LV diastolic dysfunction is controversial. Databases (MEDLINE, PubMed, EMBASE) were searched for cross-sectional studies evaluating LV diastolic function in SCH patients aged <60 years using tissue Doppler echocardiography (TDE) and conventional two-dimensional Doppler echocardiography (2D-DECG) published in the past 12 years. The weighted mean difference (WMD) and 95% confidence interval (CI) were calculated using fixed or random-effects models. We summarized the results of 14 cross-sectional studies with 675 participants. SCH patients had a significantly lower LV mitral annular E(a) peak velocity (WMD=-1.71 cm/s; 95%CI: -3.02 to -0.40; p<0.05), E(a)/A(a) ratio (WMD=-0.22; 95%CI: -0.40 to -0.05; p<0.05), and significantly higher mitral annular A(a) peak velocity (WMD=0.47 cm/s; 95%CI: 0.10-0.85; p<0.05) than euthyroid subjects using TDE. Subgroup analyses showed that statistical significance existed only in E(a) and E(a)/A(a) parameters when data from "women ≥ 90%" were used, and in the A(a) parameter when data from "women<90%" were used. No matter which subgroup of females was used, there were significant differences in LV peak transmitral A velocity (WMD=7.64 cm/s; 95%CI: 4.55-10.73; p<0.05), and E/A ratio (WMD=-0.22; 95%CI: -0.31 to -0.21; p<0.05) but no significant difference in peak transmitral E velocity (p>0.05) between SCH patients and euthyroid controls using 2D-DECG. Therefore, for those aged <60 years, SCH patients had significantly worse parameters of LV diastolic function than euthyroid controls.

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