Heart ventricular function in hospitalized patients with severe hypothyroidism and myxedema coma
Authors' conclusion
Severe hypothyroidism is associated with frequent systolic and diastolic ventricular dysfunction and prevalent impairment of myocardial deformation. Associations between cardiovascular medication exposure and echocardiographic abnormalities likely reflect confounding by indication and underlying clinical phenotype rather than reflecting causal drug effects. Despite substantial myocardial abnormalities, short-term mortality was low.
Study context
- Population
- Adults admitted to ICUs with severe hypothyroidism who underwent transthoracic echocardiography during hospitalization; mean age 53.9 ± 13.7 years, 64.3% female; myxedema coma in 33 (29.5%)
- Participants
- 112 adults
- Outcome
- LV systolic and diastolic function and myocardial deformation (GLS) on echocardiography
Methodological detailsmulticenter, retrospective
- Multicenter
- Retrospective
Main finding
As reported in the abstract
Ventricular function
- Mean left ventricular (LV) ejection fraction (LV ejection fraction (LVEF))
- 53.9 ± 13.7%
- Mean LV global longitudinal strain (GLS) (reference −24% to −16%)
- −13.5 ± 4.2%
- Mean right ventricular (RV) GLS (reference −35% to −17%)
- −17.9 ± 6%
- Reduced LVEF
- 37.5%
- Abnormal LV diastolic function
- 66.7%
- Impaired LV GLS
- 68.2%
- Impaired RV GLS
- 34.0%
Observational data: associations, not effects.
Further findings
Admission TSH · median admission
- Median admission TSH (mIU/L)
- 113.9 (41.9-500.0)
Cardiovascular medication and echocardiographic findings (multivariable models)
- β-blocker treatment associated with lower LVEF and worse biventricular GLS
- ACE inhibitor/ARB treatment associated with lower LVEF
- Calcium channel blocker exposure associated with improved RV GLS
In-hospital mortality
- In-hospital mortality, occurring in patients with preserved LVEF
- 4.5%
Original publication
Heart ventricular function in hospitalized patients with severe hypothyroidism and myxedema coma. J Clin Endocrinol Metab. Published 30 January 2026. doi:10.
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