الفهرس 
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Abstract
Hypothyroidism is a prevalent endocrine condition, with reported prevalence rates of subclinical hypothyroidism reaching as high as 10% in some studies. Hypothyroidism is often identified through the observation of reduced levels of thyroid hormones, leading to an increase in thyroid stimulating hormone (TSH) levels. On the other hand, subclinical hypothyroidism is diagnosed when TSH levels exceed the upper limit of the reference range established by the assay, while thyroid hormone levels remain within the normal range. Thyroid hormones are known to have a significant impact on the proper functioning of the cardiovascular system, particularly in relation to cardiac and vascular physiology. The condition of hypothyroidism, characterized by an underactive thyroid gland, can result in substantial cardiovascular consequences. The impact of subclinical hypothyroidism on cardiovascular disease and the appropriateness of its treatment have emerged as subjects of current clinical concern.
The objective of this study was to evaluate the echocardiographic alterations in individuals diagnosed with clinical or subclinical hypothyroidism, as well as to determine whether the administration of medication to restore normal thyroid function could result in enhancements in both cardiac systolic and diastolic performance.
The study comprised a total of 74 participants who were treated to:
Thorough history taking and comprehensive clinical examination are essential components of the diagnostic process.
There are twelve resting electrocardiogram (ECG) leads.
The collection of blood samples is an essential component in various scientific and medical research studies.
The concept of routine refers to a set of regular and repeated activities or behaviors that individuals engage in on a consistent basis. One of the samples that might be included in a medical examination is a complete blood count.
The parameters being discussed include HbA1C, fasting blood sugar, and random blood sugar.
The topic of interest is renal function, namely the measurement of urea and creatinine levels.
The topic of interest is to the assessment of liver function by the measurement of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels.
The lipid profile and thyroid tests, namely the measurement of thyroid peroxidase antibodies, were conducted.
The presence of anti-thyroglobulin antibodies.
During the initial visit, blood samples were collected to diagnose hypothyroidism by measuring levels of TSH, Free T3, and Free T4. These measurements were thereafter repeated every two weeks to monitor the patient’s progress and make necessary adjustments to the levothyroxine dosage.
The cardiac architecture and function were evaluated using Two D speckle tracking echocardiography prior to initiating treatment, and subsequently repeated three months after achieving euthyroid stage.
The people that were involved in the study were categorized into three distinct groups. The first group consisted of 24 individuals who had recently been diagnosed with clinical hypothyroidism. The second group consisted of 24 individuals who had recently been diagnosed with subclinical hypothyroidism. The third group, which served as the control group, had 26 euthyroid participants.
Our study revealed that there was no statistically significant difference in LV Global longitudinal strain (GLS), E/A, E/E’, and LV EF% between the clinical and subclinical hypothyroidism groups.
A statistically significant difference was observed among the three groups in terms of LV Global longitudinal strain (GLS), E/A, and E/E’. The clinical hypothyroidism group and subclinical hypothyroidism group exhibited impairment in these measures compared to the control group. However, no statistically significant difference was found in LV EF% among the groups.
Following a three-month period in the euthyroid stage, there was a notable and statistically significant enhancement observed in the values of GLS, E/A, E/E’, and EF% as compared to their respective baseline parameters.