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To the Editor: In their Scientific Review and Clinical Applications article about subclinical thyroid disease, Dr Surks and colleagues¹ stated that numerous small studies reveal subtle decreases in myocardial contractility in patients with subclinical hypothyroidism. Although the authors cited our review article² in making this claim, they did not mention that we found diastolic dysfunction to be the most consistent cardiac abnormality in this disease. Furthermore, we reported that it tends to regress with replacement of thyroid hormone. This finding has been independently reported elsewhere.^2-4

Furthermore, diastolic dysfunction has been reported not only in patients with thyroid-stimulating hormone (TSH) levels greater than 10 mU/L but also in those with TSH values between 4.5 and 10 mU/L.^2-3 In contrast to this pattern with diastolic dysfunction, Surks et al reported that whereas lipid profiles are frequently abnormal when TSH levels are greater than 10 mU/L, they are seldom so in the lower . . . [Full Text of this Article]

Bernadette Biondi, MD; Gaetano Lombardi, MD
Department of Clinical and Molecular Endocrinology and Oncology

Emiliano A. Palmieri, MD
Department of Clinical Medicine and Cardiovascular Sciences
University of Naples Federico II School of Medicine
Naples, Italy

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