This study aimed to evaluate the left ventricular
(LV) functions in a cohort of children with Graves’ disease
(GD). This is a cross-sectional case-control study. It included
36 children with GD and 36 healthy children matched for age
and gender. Thyroid hormones (TSH, FT4, and FT3) and antithyroid
autoantibodies [anti-thyroid peroxidase (anti-TPO),
thyrotropin receptor (TRAbs), and thyroglobulin antibodies]
were measured. Conventional and tissue Doppler imaging
(TDI) echocardiographies were used to assess left ventricular
systolic and diastolic functions. LV mass index (LVMI) and
myocardial performance index (MPI) were also measured.
Compared to healthy children, conventional echocardiography
of patients with GD revealed higher LVMI (P = 0.001)
indicating LV hypertrophy but normal LV functions while
TDI revealed lower Em/Am ratio indicating LV diastolic dysfunction
(P = 0.001). Significant correlations were reported
between FT4 with LVMI (P = 0.05), Em/Am (P = 0.01), and
MPI (P = 0.01). In multivariate analysis, a positive correlation
was identified between FT4 with MPI (OR = 1.17; 95% CI
= 1.09–1.15; P = 0.001).
Conclusions: Children with newly diagnosed GD may
have significant subclinical changes in LV structure and function
(diastolic and global). TDI is more sensitive than conventional
Doppler in detecting LV dysfunction. These findings
highlight the importance of early monitoring of children with
GD for left ventricular mass index and diastolic function.
What is Known:
• There is an increased risk for cardiac abnormalities in children with
Graves’ disease (GD).
• Limited studies assessed left ventricular function in patients with GD.
What is New:
• Children with newly diagnosed GD may have significant subclinical
changes in left ventricular structure and functions.
• Children with newly diagnosed GD should be monitored for left
ventricular mass index and diastolic function.