الفهرس 
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Abstract
Hashimoto thyroiditis (HT) is the most common cause of thyroid diseases in children and adolescents, and it is also the most common cause of acquired hypothyroidism in iodine-sufficient areas. Thyroid hormone levels affect many biological functions including the cardiovascular system. Ventricular myocardial dysfunction associated with euthyroid HT has been suggested to be related to the abnormal inflammatory state associated with autoimmunity as well as to endocrine effect.
In the current study, we studied the cardiac functions in HT patients by using conventional Echocardiography parameters and STE and both were correlated to the thyroid hormones level, auto-antibodies level, lipid profile and duration of the disease. Conventional Echocardiography parameters and their z-score showed no statistically significant difference between controls group and patients’ group and parameters were within normal range for both groups. Using STE, LVGLS measured for both groups was within normal. In our study, Further comparison between newly diagnosed patients with HT within one month after diagnosis and known HT patients with a disease duration ranging from 21 to 50 months as regards LVGLS showed a lower mean in already known patients than newly diagnosed patients so that the cardiac affection might be attributed to the state of chronic disease and the duration of the presence of autoantibodies. There was no correlation between cardiac functions and level of antibodies. CIMT was used as indicator for atherosclerosis, there was no significant difference between patient and control group as regards CIMT. Lipid profile showed no significant difference between both groups. However, there was positive correlation between duration of disease and CIMT z-score. This finding supported the hypothesis that chronic inflammation state with autoimmunity is the risk factors for the atherosclerosis associated with HT regardless the thyroid hormones.11
CONCLUSION
We concluded that patients with HT have myocardial affection which could be attributed to the duration of the disease and the chronic inflammatory state even with normal thyroid functions.
Myocardial dysfunction could not be assessed using conventional echocardiography parameters, while LVGLS can early detect the myocardial dysfunction on initial examination and follow up.
RECOMMENDATIONS
1- To use speckle tracking echocardiography as standard investigation of cardiac function in patients with Hashimoto thyroiditis at time of initial diagnosis.
2- To use speckle tracking echocardiography for follow up cardiac function of patients with Hashimoto thyroiditis for early detection of subclinical cardiomyopathy.
3- Further clinical research is needed with larger patient groups to investigate the effect and mechanisms of myocardial dysfunction with normal LV EF in patients with Hashimoto thyroiditis.