Assessment of Left Ventricular Strain Echocardiography in Individuals with Hashimoto’s Thyroiditis and Its Association with Serum TIMP-1 Concentration

Abstract Background and Aim: Hashimoto's thyroiditis (HT), which is an autoimmune condition and the primary cause of hypothyroidism, has numerous impacts on the cardiovascular system. Speckle-tracking echocardiography (STE) enables earlier detection of left ventricular (LV) dysfunction compared to conventional echocardiography. The tissue inhibitor of metalloproteinase-1 (TIMP-1) is a key molecule that plays a role in cardiac remodeling in various pathologies. The objective of this study was to determine if any differences existed in TIMP-1 levels and LV strain values between euthyroid HT patients, hypothyroid HT patients, and healthy control subjects. Materials and Methods: Forty patients with hypothyroid HT, 40 HT patients who had become euthyroid with thyroid hormone replacement therapy, and 40 healthy controls were included in this study. In addition to conventional echocardiography, all subjects also underwent STE. Segmental and global LV longitudinal strain values (LVGLS) were obtained. Blood samples were collected from each participant to measure serum TIMP-1 levels, thyroid function tests and thyroid peroxidase (TPO) antibody (anti-TPO) levels. Results: Higher serum TIMP-1 levels were found in euthyroid and hypothyroid HT patients than in control group. Additionally, patients with euthyroid and hypothyroid HT displayed lower segmental and global LV strain values than the control group. A negative correlation was observed between strain values and TIMP-1 and anti-TPO levels. No significant difference was observed in serum TIMP-1 and strain values between euthyroid and hypothyroid HT patients. Patients with hypothyroid HT exhibited impaired diastolic function and reduced ejection fraction when compared to both euthyroid HT and control groups. However, diastolic function and ejection fraction were similar between euthyroid HT patients and the control group. Conclusion: Hashimoto's thyroiditis causes impairment of LV strain, regardless of thyroid hormone levels. Additionally, the condition is associated with elevated TIMP-1 levels. The relationship between LV strain values and anti-TPO levels indicates that the autoimmune component of the disease may be responsible for the impaired LV strain.