Thickening of the epicardial adipose tissue can be alleviated by thyroid hormone replacement therapy in patients with subclinical hypothyroidism

Background: Subclinical hypothyroidism (SCH) is a common disorder which has adverse cardiovascular effects. Epicardial adipose tissue (EAT), a novel marker of cardiovascular risk, is increased in SCH. Aim: We aimed to investigate whether L-thyroxine treatment can reverse the thickening of EAT in SCH. Methods: Forty-four patients with SCH and 42 euthyroid control subjects were included. EAT thickness was measured using transthoracic echocardiography at baseline and after restoration of the euthyroid status with 3 months of L-thyroxine treatment. Results: At baseline, mean EAT thickness was significantly greater in the SCH group when compared to the control group (6.3 ± 1.7 mm vs. 4.1 ± 0.9 mm, respectively, p < 0.001). There was a significant positive correlation between baseline serum thyroid stimulating hormone (TSH) level and EAT thickness in the SCH group. There was a significant reduction in mean EAT thickness in response to L-thyroxine treatment (6.3 ± 1.7 mm vs. 5.1 ± 1.4 mm, p < 0.001). The decrease in EAT thickness after L-thyroxine treatment when compared to baseline (DEAT) significantly correlated to the difference in TSH levels before and after treatment (DTSH; r = 0.323; p = 0.032). Conclusions: Epicardial adipose tissue thickness is increased in patients with SCH. This thickening was alleviated with restoration of the euthyroid status with L-thyroxine treatment in our study population of predominantly male, relatively old subjects with greater baseline EAT thickness

A Comparison of Two Electrophysiology Centers in Different Social And Economic Regions Of Turkey During First Quarter of the Year

Introduction: More and more patients have been undergoing electrophysiological study (EPS) as the number of rhythmologists have increased. Due to the increased interest in the study, today EPS applications are made even in second step public hospitals or private hospitals. Our aim is to compare two electrophysiology labs, that are in different regions with social and economic development, in terms of patient demography, diagnosis, amount of diagnostic and curative interventions. Materials and Methods: In this study, two centers from two different regions of Turkey were selected; a training and research center (center 1) in the Western part and a public hospital (center 2) in the Eastern part of the country. Records of the patients who undergone EPS in these two centers were retrospectively analyzed. Independent parametric data were evaluated by T-test, and categorical data via Mann-Whitney U test. A p value below 0.05 was accepted for significance. Results: A total of 83 patients were retrospectively analyzed (42 from center 1, 41 from center 2). Patients’ baseline demographic data was similar except intellectual status. Nevertheless, both groups differed based on the number of patients with diagnosis of atrioventricular reciprocating tachycardia (p=0.047). There was a significant difference in procedure types. Center 1 performed significantly higher number of curative procedures (p=0.039) than center 2. Conclusions: Nowadays, EPS is spread from specialized centers to middle-sized hospitals. Since specialized centers have more access to the advanced devices such as electro-anatomic mapping rather than conventional equipment, they are evaluating more complex cases with a variety of different diagnosis. Constructing a referral system from peripheral hospitals to distinguished centers in electrophysiology field would eliminate unnecessary and/or repeated procedures and decrease the expenses

Wpływ suplementacji hormonów tarczycy na ograniczenie przyrostu nasierdziowej tkanki tłuszczowej u chorych z subkliniczną niedoczynnością tarczycy

Background: Subclinical hypothyroidism (SCH) is a common disorder which has adverse cardiovascular effects. Epicardial adipose tissue (EAT), a novel marker of cardiovascular risk, is increased in SCH. Aim: We aimed to investigate whether L-thyroxine treatment can reverse the thickening of EAT in SCH. Methods: Forty-four patients with SCH and 42 euthyroid control subjects were included. EAT thickness was measured using transthoracic echocardiography at baseline and after restoration of the euthyroid status with 3 months of L-thyroxine treatment. Results: At baseline, mean EAT thickness was significantly greater in the SCH group when compared to the control group (6.3 ± 1.7 mm vs. 4.1 ± 0.9 mm, respectively, p &lt; 0.001). There was a significant positive correlation between baseline serum thyroid stimulating hormone (TSH) level and EAT thickness in the SCH group. There was a significant reduction in mean EAT thickness in response to L-thyroxine treatment (6.3 ± 1.7 mm vs. 5.1 ± 1.4 mm, p &lt; 0.001). The decrease in EAT thickness after L-thyroxine treatment when compared to baseline (DEAT) significantly correlated to the difference in TSH levels before and after treatment (DTSH; r = 0.323; p = 0.032). Conclusions: Epicardial adipose tissue thickness is increased in patients with SCH. This thickening was alleviated with restoration of the euthyroid status with L-thyroxine treatment in our study population of predominantly male, relatively old subjects with greater baseline EAT thickness.  Wstęp: Subkliniczna niedoczynność tarczycy (SCH) jest częstym zaburzeniem niekorzystnie wpływającym na układ sercowo-naczyniowy. U chorych z SCH stwierdza się zwiększenie grubości nasierdziowej tkanki tłuszczowej (EAT) — nowego wskaźnika ryzyka sercowo-naczyniowego. Cel: Badanie przeprowadzono w celu ustalenia, czy leczenie L-tyroksyną może zmniejszyć grubość EAT u tych chorych. Metody: Do badania włączono 44 chorych z SCH i 42 osoby z eutyreozą, które stanowiły grupę kontrolną. Na początku badania i po przywróceniu eutyreozy w wyniku 3-miesięcznego leczenia L-tyroksyną zmierzono grubość EAT metodą echokardiografii przezprzełykowej. Wyniki: Na początku badania średnia grubość EAT była istotnie większa w grupie SCH niż w grupie kontrolnej (odpowiednio 6,3 ± 1,7 mm vs. 4,1 ± 0,9 mm; p &lt; 0,001). W grupie SCH stwierdzono istotną dodatnią korelację między początkowym stężeniem TSH w surowicy a grubością EAT. Po leczeniu L-tyroksyną nastąpiła istotna redukcja średniej grubości EAT (6,3 ± 1,7 mm vs. 5,1 ± 1,4 mm; p &lt; 0,001). Zmniejszenie grubości EAT po leczeniu L-tyroksyną w stosunku do wartości początkowych (DEAT) korelowało istotnie z różnicą stężeń TSH przed terapią i po jej zakończeniu (DTSH; r = 0,323; p = 0,032). Wnioski: U chorych z SCH grubość EAT jest zwiększona. W populacji niniejszego badania, złożonej głównie z mężczyzn w starszym wieku z większą początkową grubością EAT, zmniejszono ilość nasierdziowej tkanki tłuszczowej dzięki przywróceniu eutyreozy poprzez leczenie L-tyroksyną.