ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Thyroid Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1566029
Early cardiac involvement in patients with hyperthyroidism evaluated by cardiac magnetic resonance feature tracking
Provisionally accepted
- 1Shanghai General Hospital, Shanghai, China
- 2Anhui Medical University, Hefei, Anhui Province, China
- 3Philips Healthcare (China), Shanghai, China
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Background: To investigate the feasibility of quantitative assessment of myocardial injury in the early stages of the disease by myocardial strain in patients with hyperthyroidism.Results: Forty-five individuals in the hyperthyroid state with at least one index of cardiac involvement (cardiac symptoms, abnormal electrocardiogram, or abnormal cardiac biomarkers) and twenty-six healthy controls were subjected to CMR to assess left ventricular (LV) volumetry, LV mass index (LVMi), LV ejection fraction (LVEF), myocardial strain and total (TEF), passive (PEF) and active (AEF) left atrial (LA) emptying fractions. Patients with hyperthyroidism were classified into two categories according to the presence (n=40) or absence (n=5) of atrial fibrillation (AF).LA reservoir, conduit, and booster strains were significantly impaired in all patients with hyperthyroidism (all p<0.01). In contrast, LA and LV ejection fraction, LVMi and LV myocardial strain showed no significant differences between cases without AF and healthy controls (all p>0.05). LA-AEF and LV-EF were significantly decreased in hyperthyroidism cases with AF compared with hyperthyroidism cases without AF, although no significant differences in LA-TEF, PEF and LVMi were detected. ROC curve analysis revealed superior diagnostic value for the LA reservoir strain, which distinguished hyperthyroidism cases from normal subjects with a sensitivity of 80.8% and a specificity of 80%.Conclusions: LA strain reliably differentiates early cardiac involvement between patients with hyperthyroidism and healthy controls, whereas volumetric parameters and ventricular myocardial strain fail to do so.
Keywords: Hyperthyroidism, Atrial Fibrillation, Quantitative evaluation, FeatureTracking, cardiovascular resonance magnetic imaging
Received: 24 Jan 2025; Accepted: 25 Apr 2025.
Copyright: © 2025 Zhang, Jia, Ge, Luo, Zhao, Xing, Liu and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Fang Liu, Shanghai General Hospital, Shanghai, China
Lei Zhang, Shanghai General Hospital, Shanghai, China
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