Assessment of the elasticity properties of the ascending aorta in patients with subclinical hypothyroidism by tissue Doppler imaging

Avaliação das propriedades de elasticidade da aorta ascendente em pacientes com hipotiroidismo subclínico por imagem de Doppler tecidual

LETTER TO THE EDITOR

Assessment of the elasticity properties of the ascending aorta in patients with subclinical hypothyroidism by tissue Doppler imaging

Avaliação das propriedades de elasticidade da aorta ascendente em pacientes com hipotiroidismo subclínico por imagem de Doppler tecidual

Mustafa YurtdaşI; Türkay ÖzcanII; Ramazan GenIII; Mehmet Kasım AydınIV

IDepartment of Cardiology, Van Region Training and Research Hospital, Van, Turkey

IIDepartment of Cardiology, Mersin University, Mersin, Turkey

IIIDepartment of Endocrinology, Mersin University, Mersin, Turkey

IVDepartment of Internal Medicine, Mersin University, Mersin, Turkey

Correspondence to

We appreciate the well-written correspondence of Balta and cols. that was sent to journal regarding our manuscript "Assessment of the elasticity properties of the ascending aorta in patients with subclinical hypothyroidism by tissue Doppler imaging" (1).

Elastic properties and wall movements of the ascending aorta can be affected by several risk factors, such as age, diabetes mellitus (DM), hypertension (HT), and smoking (2-6). As DM and HT are known to have an unfavorable effect on arterial stiffness (3-6), diabetic and hypertensive patients were not enrolled in our study. In addition, some inflammatory diseases (7,8), including Behcet disease, systemic lupus erythematosus, and psoriasis, which may be diagnosed by detailed physical examination and laboratory findings, may be related with arterial stiffness parameters. On the other hand, we have established that all participants in our manuscript were normal in terms of physical examination, medical history, and inflammatory markers. Studied individuals did have new diagnosis of subclinical hypothyroidism and hyperlipidemia (HL). None of them received the medication(s) for DM, HT, HL and weight loss before and during the study. In addition, we excluded subjects that received medications (such as beta-blocker and weight loss drugs) that could influence heart rate levels.

The measurment of arterial stiffness is a practical, useful, and non-invasive technique for identifying potential cardiovascular risk (9,10). Arterial stiffness may be used for early determination of patients at risk in clinical practice (9,10). Elevated arterial stiffness can independently predict cardiovascular problems in both healthy adults and subjects with clinical or metabolic disorders (2-6). As mentioned before, several factors might affect arterial stiffness, such as age, dyslipidemia, body weight, and heart failure (10). Thus, arterial stiffness alone may not provide a definitive diagnostic result to clinicians in relation to endothelial dysfunction and/or inflammation, but could be suitable as an early marker of cardiovascular risk. Therefore, we would advocate that the cardiologist and/or endocrinologist analysed other inflammatory markers if early diagnosis of arterial stiffness has shown that an individual is at risk for developing cardiovascular disease.

Received on May/17/2013

Accepted on Jun/6/2013

  • 1. Yurtdaş M, Gen R, Özcan T, Aydın MK. Assessment of the elasticity properties of the ascending aorta in patients with subclinical hypothyroidism by tissue Doppler imaging. Arq Bras Endocrinol Metab. 2013;57(2):132-8.
  • 2. Willum-Hansen T, Staessen JA, Torp-Pedersen C, Rasmussen S, Thijs L, Ibsen H, et al. Prognostic value of aortic pulse wave velocity as index of arterial stiffness in the general population. Circulation. 2006;113:664-70.
  • 3. Karamitsos TD, Karvounis HI, Didangellos TP, Papadopoulos CE, Dalamanga EG, Karamitsos DT, et al. Usefulness of colour tissue Doppler imaging in assessing aortic elastic properties in type 1 diabetic patients. Diabet Med. 2006;23:1201-6.
  • 4. Cruickshank K, Riste L, Anderson SG, Wright JS, Dunn G, Gosling RG. Aortic pulse-wave velocity and its relationship to mortality in diabetes and glucose intolerance: an integrated index of vascular function? Circulation. 2002;106:2085-90.
  • 5. Vitarelli A, Giordano M, Germano G, Pergolini M, Cicconetti P, Tomei F, et al. Assessment of ascending aorta wall stiffness in hypertensive patients by tissue Doppler imaging and strain Doppler echocardiography. Heart. 2010;96:1469-74.
  • 6. Boutouyrie P, Tropeano AI, Asmar R, Gautier I, Benetos A, Lacolley P, et al. Aortic stiffness is an independent predictor of primary coronary events in hypertensive patients: a longitudinal study. Hypertension. 2002;39:10-15.
  • 7. Viggiano DPPO, Da Silva NA, Montandon ACOES, Barbosa V de S. [Prevalence of thyroid autoimmune disease in patients with systemic lupus erythematosus]. Arq Bras Endocrinol Metab. 2008;52:531-6.
  • 8. Soy M, Yildiz M, Uyanik MS, Karaka N, Güfer G, Piksin S. Susceptibility to atherosclerosis in patients with psoriasis and psoriatic arthritis as determined by carotid-femoral (aortic) pulse-wave velocity measurement. Rev Esp Cardiol. 2009;62:96-9.
  • 9. Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2006;27:2588-605.
  • 10. Albu A, Fodor D, Bondor C, Poanta L. Arterial stiffness, carotid atherosclerosis and left ventricular diastolic dysfunction in postmenopausal women. Eur J Intern Med. 2013;24:250-4.

  • Correspondence to:
    Mustafa Yurtdaş
    Van Region Training and Research Hospital, Department of Cardiology, 65100 – Van, Turkey

Publication Dates

  • Publication in this collection
    25 July 2013
  • Date of issue
    July 2013
Sociedade Brasileira de Endocrinologia e Metabologia Rua Botucatu, 572 - conjunto 83, 04023-062 São Paulo, SP, Tel./Fax: (011) 5575-0311 - São Paulo - SP - Brazil
E-mail: abem-editoria@endocrino.org.br