Evaluation of Left Ventricular Functions in Patients with Primary Hyperparathyroidism: is There Any Effect of Parathyroidectomy?

Overview

Journal Wien Klin Wochenschr

Publisher Springer

Specialty General Medicine

Date 2017 Mar 19

PMID 28314925

Citations 4

Authors

Alper Kepez

Mehmet Yasar

Murat Sunbul

Cigdem Ileri

Oguzhan Deyneli

Bulent Mutlu

Osman Yesildag

Yelda Basaran

Affiliations

Soon will be listed here.

Abstract

Purpose: Our aim was to evaluate left ventricular (LV) systolic and diastolic functions of primary hyperparathyroidism (pHPT) patients with detailed echocardiographic analysis and investigate the effect of parathyroidectomy on echocardiographic parameters.

Methods: A total of 22 eligible consecutive patients with pHPT who underwent parathyroidectomy operation were recruited to the study. Another 22 subjects with similar age, gender and frequency of cardiovascular risk factors compared to patients were used as a control group. Echocardiographic parameters of patients scheduled for parathyroidectomy were compared to healthy matched controls. Echocardiographic parameters measured 6 months after the operation were also compared with preoperative values for each patient.

Results: Patients had higher LV mass index compared with controls. There were no significant differences between groups regarding 2D echocardiographic parameters reflecting LV systolic function and tissue Doppler velocities; however, 2D echocardiographic parameters demonstrated impairment in LV diastolic functions compared with controls. Speckle tracking echocardiography (STE) demonstrated similar LV global longitudinal systolic strain; however, left atrial conduit and reservoir functions were significantly reduced in patients with pHPT. In general, there were no significant differences between baseline and postoperative state regarding parameters reflecting LV systolic and diastolic functions; however, STE demonstrated significantly increased LV global longitudinal strain after surgery (22.3 ± 3.3% vs 20.3 ± 2.9%, p = 0.026).

Conclusion: Patients with pHPT displayed higher LV mass and impairment in LV diastolic function compared with controls. Parathyroidectomy did not lead to significant improvements in LV mass or LV diastolic function; however, subtle but not apparent increases in LV systolic function were observed 6 months after surgery.

Citing Articles

Improvement of hypertension control and left-ventricular function after cure of primary hyperparathyroidism.

Karwacka I, Kmiec P, Kaniuka-Jakubowska S, Pisowodzka I, Fijalkowski M, Sworczak K Front Endocrinol (Lausanne). 2023; 14:1163877.

PMID: 37492200 PMC: 10364630. DOI: 10.3389/fendo.2023.1163877.

Factors associated with changes in echocardiographic parameters following kidney transplantation.

dHerve Q, Girerd N, Bozec E, Lamiral Z, Panisset V, Frimat L Clin Res Cardiol. 2023; 113(3):412-424.

PMID: 37084138 DOI: 10.1007/s00392-023-02203-6.

The preliminary study on cardiac structure and function in Chinese patients with primary hyperparathyroidism.

Chen R, Song A, Wang O, Jiang Y, Li M, Xia W Front Endocrinol (Lausanne). 2023; 14:1083521.

PMID: 36824357 PMC: 9941322. DOI: 10.3389/fendo.2023.1083521.

Impact of curative parathyroidectomy on left ventricular functions assessed with 2D ECHO and MUGA study.

Abuji K, Dahiya D, Sood A, Parmar M, Bhadada S, Vijayvergiya R Turk J Surg. 2022; 37(4):336-341.

PMID: 35677493 PMC: 9130932. DOI: 10.47717/turkjsurg.2021.5167.

References

Almqvist E, Bondeson A, Bondeson L, Nissborg A, Smedgard P, Svensson S . Cardiac dysfunction in mild primary hyperparathyroidism assessed by radionuclide angiography and echocardiography before and after parathyroidectomy. Surgery. 2002; 132(6):1126-32; discussion 1132. DOI: 10.1067/msy.2002.128692. View

Piovesan A, Molineri N, Casasso F, Emmolo I, Ugliengo G, Cesario F . Left ventricular hypertrophy in primary hyperparathyroidism. Effects of successful parathyroidectomy. Clin Endocrinol (Oxf). 1999; 50(3):321-8. DOI: 10.1046/j.1365-2265.1999.00651.x. View

Kepez A, Harmanci A, Hazirolan T, Isildak M, Kocabas U, Ates A . Evaluation of subclinical coronary atherosclerosis in mild asymptomatic primary hyperparathyroidism patients. Int J Cardiovasc Imaging. 2008; 25(2):187-93. DOI: 10.1007/s10554-008-9369-2. View

Nappi S, Saha H, Virtanen V, Limnell V, Sand J, Salmi J . Left ventricular structure and function in primary hyperparathyroidism before and after parathyroidectomy. Cardiology. 2000; 93(4):229-33. DOI: 10.1159/000007031. View

LAFFERTY F . Primary hyperparathyroidism. Changing clinical spectrum, prevalence of hypertension, and discriminant analysis of laboratory tests. Arch Intern Med. 1981; 141(13):1761-6. DOI: 10.1001/archinte.141.13.1761. View

Barletta G, De Feo M, Del Bene R, Lazzeri C, Vecchiarino S, LA VILLA G . Cardiovascular effects of parathyroid hormone: a study in healthy subjects and normotensive patients with mild primary hyperparathyroidism. J Clin Endocrinol Metab. 2000; 85(5):1815-21. DOI: 10.1210/jcem.85.5.6514. View

Kosch M, Hausberg M, Vormbrock K, Kisters K, Rahn K, Barenbrock M . Studies on flow-mediated vasodilation and intima-media thickness of the brachial artery in patients with primary hyperparathyroidism. Am J Hypertens. 2000; 13(7):759-64. DOI: 10.1016/s0895-7061(00)00248-x. View

Langle F, Abela C, Mittelbock M, Bergler-Klein J, Stefenelli T, Woloszczuk W . Primary hyperparathyroidism and the heart: cardiac abnormalities correlated to clinical and biochemical data. World J Surg. 1994; 18(4):619-24. DOI: 10.1007/BF00353780. View

Nilsson I, Aberg J, Rastad J, Lind L . Left ventricular systolic and diastolic function and exercise testing in primary hyperparathyroidism-effects of parathyroidectomy. Surgery. 2000; 128(6):895-902. DOI: 10.1067/msy.2000.110240. View

10.

Andersson P, Rydberg E, Willenheimer R . Primary hyperparathyroidism and heart disease--a review. Eur Heart J. 2004; 25(20):1776-87. DOI: 10.1016/j.ehj.2004.07.010. View

11.

Kovacs L, Goth M, Szabolcs I, Dohan O, FERENCZ A, Szilagyi G . The effect of surgical treatment on secondary hyperaldosteronism and relative hyperinsulinemia in primary hyperparathyroidism. Eur J Endocrinol. 1998; 138(5):543-7. DOI: 10.1530/eje.0.1380543. View

12.

Baczynski R, Massry S, Kohan R, Magott M, Saglikes Y, Brautbar N . Effect of parathyroid hormone on myocardial energy metabolism in the rat. Kidney Int. 1985; 27(5):718-25. DOI: 10.1038/ki.1985.71. View

13.

Smogorzewski M, Zayed M, Zhang Y, Roe J, Massry S . Parathyroid hormone increases cytosolic calcium concentration in adult rat cardiac myocytes. Am J Physiol. 1993; 264(6 Pt 2):H1998-2006. DOI: 10.1152/ajpheart.1993.264.6.H1998. View

14.

Bukoski R, Ishibashi K, Bian K . Vascular actions of the calcium-regulating hormones. Semin Nephrol. 1995; 15(6):536-49. View

15.

Isales C, Sumpio B, Bollag R, Zhong Q, Ding K, Du W . Functional parathyroid hormone receptors are present in an umbilical vein endothelial cell line. Am J Physiol Endocrinol Metab. 2000; 279(3):E654-62. DOI: 10.1152/ajpendo.2000.279.3.E654. View

16.

Schluter K, Weber M, Piper H . Parathyroid hormone induces protein kinase C but not adenylate cyclase in adult cardiomyocytes and regulates cyclic AMP levels via protein kinase C-dependent phosphodiesterase activity. Biochem J. 1995; 310 ( Pt 2):439-44. PMC: 1135914. DOI: 10.1042/bj3100439. View

17.

Hedback G, Oden A . Increased risk of death from primary hyperparathyroidism--an update. Eur J Clin Invest. 1998; 28(4):271-6. DOI: 10.1046/j.1365-2362.1998.00289.x. View

18.

Nilsson I, Yin L, Lundgren E, Rastad J, Ekbom A . Clinical presentation of primary hyperparathyroidism in Europe--nationwide cohort analysis on mortality from nonmalignant causes. J Bone Miner Res. 2002; 17 Suppl 2:N68-74. View

19.

Devereux R, Reichek N . Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation. 1977; 55(4):613-8. DOI: 10.1161/01.cir.55.4.613. View

20.

Smogorzewski M, Perna A, Borum P, Massry S . Fatty acid oxidation in the myocardium: effects of parathyroid hormone and CRF. Kidney Int. 1988; 34(6):797-803. DOI: 10.1038/ki.1988.252. View