Parameters of Lipidemia, Coronary Blood Flow and Global Longitudinal Strain of Myocardium in Patients with Subclinical Hypothyroidism in Combination with Stable Angina
Objective: to provide the characteristics of lipid profile, coronary blood flow and functional myocardium condition in patients with combination of subclinical hypothyroidism (SH) and coronary heart disease (CHD). Materials and methods. The study involved 40 women aged from 55 to 75 years with primary CH which were divided into two groups: group 1 consisted of 20 women with SH alone and group 2 consisted of 20 women with SH in combination with CHD of II functional class. Control group included 20 women without thyroid diseases and CHD. Physical examination, assessment of total cholesterol (TC), cholesterol of low density lipids (LDL), cholesterol of high density cholesterol (HDL), cholesterol of non high density lipids (C-non-HDL), triglycerides (TG), transthoracic EchoCG, coronary bloodflow assessment and global LV longitudinal strain by speckle tracking method were performed to all patients. Results. There were no significant differences in median of TC, C-LDL, C-HDL in the examined groups. The level of C-HDL in patients with SH in combination with CHD was significantly lower than in control group and in patients with SH alone. We revealed increase of TC, C-LDL, C-non-HDL and decrease of C-HDL together with obesity or overweight in patients with SH plus CHD. Such patients had deterioration of global longitudinal strain on the background of more severe LV hypertrophy, diastolic dysfunction and decrease of coronary blood flow in left descendent artery (LAD) that require the proper therapy. Conclusion. Presence of functional and structural LV remodeling, lipid spectrum disorders, decrease of coronary bloodflow on thyroid stimulating hormone increase makes especially actual the assessment of prognosis and choice of proper therapy in the patients with SH in combination with CHD.