Objective: To explore the early diaghostic value of thyroid hormone level in patients with left ventricular diastolic dysfunction. Methods: Our work included 4 groups:①Normal control group, n=40,②Impaired left ventricular diastolic function
group, n=40,③Failure of left ventricular diastolic function group, n=41 and④Impaired left ventricular systolic function group, n=40. The cardiac function was assessed by color Doppler lfow imaging and tissue Doppler imaging for the early diastolic mitral lfow velocity (E), the peak early diastolic mitral annular velocity (Em) and the ratio of E/Em. The blood levels of NT-proBNP and FT3, FT4, TSH, rT3 were examined in clinical laboratory.
Results: Blood levels of FT3 and rT3 were different in pair wise comparison among 4 groups, P<0.05, and FT4 and NT-proBNP were different in pair wise comparison among 4 groups, except for Normal control group and Impaired left ventricular diastolic function group, P<0.05. The TSH level was similar among 4 groups, P>0.05. The ratio of E/Em was negatively related to FT3 (r=-0.724, P<0.05) and FT4 (r=-0.49, P<0.05), while positively related to rT3 (r=0.87, P<0.05) and NT-proBNP (r=0.83, P<0.05).
Conclusion: The changes of thyroid hormone level may exist in patients with impaired diastolic function and it may vary with the severity of the cardiac dysfunction. Blood levels of NT-proBNP with thyroid hormone might be used as a reference index for early diagnosis of diastolic dysfunction.

Purpose: Central lymph node metastasis (CNM) are highly prevalent but hard to detect preoperatively in papillary thyroid carcinoma (PTC) patients, while the significance of prophylactic compartment central lymph node dissection (CLND) remains controversial as a treatment option. We aim to establish a nomogram assessing risks of CNM in PTC patients, and explore whether prophylactic CLND should be recommended. Materials and Methods: One thousand four hundred thirty-eight patients from two clinical centers that underwent thyroidectomy with CLND for PTC within the period 2016–2019 were retrospectively analyzed. Univariate and multivariate analysis were performed to examine risk factors associated with CNM. A nomogram for predicting CNM was established, thereafter internally and externally validated. Results: Seven variables were found to be significantly associated with CNM and were used to construct the model. These were as follows: thyroid capsular invasion, multifocality, creatinine > 70 μmol/L, age < 40, tumor size > 1 cm, body mass index < 22, and carcinoembryonic antigen > 1 ng/mL. The nomogram had good discrimination with a concordance index of 0.854 (95% confidence interval [CI], 0.843 to 0.867), supported by an external validation point estimate of 0.825 (95% CI, 0.793 to 0.857). A decision curve analysis was made to evaluate nomogram and ultrasonography for predicting CNM. Conclusion A validated nomogram utilizing readily available preoperative variables was developed to predict the probability of central lymph node metastases in patients presenting with PTC. This nomogram may help surgeons make appropriate surgical decisions in the management of PTC, especially in terms of whether prophylactic CLND is warranted.