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While cardiovascular morbidity in papillary thyroid carcinoma (PTC) patients has largely been attributed to treatment-related factors such as TSH suppression, the potential contribution of the disease itself to early, subclinical cardiovascular vulnerability has not been well defined. To address this knowledge gap, we examined treatment-na\u00efve PTC patients for evidence of subclinical cardiovascular dysfunction. This case-control study included 36 untreated PTC patients and 20 benign nodular goiter controls. Comprehensive cardiac assessment utilized transthoracic echocardiography, tissue Doppler imaging, and two-dimensional speckle-tracking echocardiography. Serum integrin \u03b1v\u03b23 and tumor necrosis factor-alpha (TNF-\u03b1) levels were quantified via enzyme-linked immunosorbent assay. Central thyroid hormone sensitivity was assessed using the Thyroid Feedback Quantile-based Index (TFQI). Compared with controls, patients with PTC exhibited evidence of subclinical myocardial functional alterations. Circulating integrin \u03b1v\u03b23 and TNF-\u03b1 levels were significantly higher in patients with PTC. Integrin \u03b1v\u03b23 levels were associated with impaired GLS and diastolic dysfunction, whereas TNF-\u03b1 showed no direct association with echocardiographic parameters. In addition, TFQI\n                    <jats:sub>FT4<\/jats:sub>\n                    levels were increased in PTC group and demonstrated a positive correlation with circulating integrin \u03b1v\u03b23 levels, as well as an association with impaired GLS. Treatment-naive, euthyroid patients with PTC exhibit early subclinical myocardial dysfunction despite preserved ejection fraction. Impairment in GLS, derived from echocardiographic assessment, is associated with circulating integrin \u03b1v\u03b23 and altered central thyroid hormone sensitivity, reflecting early CV alterations that warrant confirmation in longitudinal studies.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-41816-5","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T21:15:08Z","timestamp":1772831708000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Subclinical myocardial dysfunction in treatment naive papillary thyroid carcinoma patients"],"prefix":"10.1038","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3886-0500","authenticated-orcid":false,"given":"Safak","family":"Akin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gokhan Giray","family":"Akgul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet Ali","family":"Gulcelik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murat","family":"Celik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uygar Cagdas","family":"Yuksel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cevdet","family":"Erdol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nese Ersoz","family":"Gulcelik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"41816_CR1","doi-asserted-by":"publisher","first-page":"7","DOI":"10.3322\/caac.21708","volume":"72","author":"RL Siegel","year":"2022","unstructured":"Siegel, R. 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