Parathyroidectomy reduced PTH levels and significantly declined pulse wave velocity by 10% (β = .10; 95% CI, 0.02-0.18), indicating improved large artery stiffness.
Does parathyroidectomy improve vascular stiffness markers such as pulse wave velocity in patients with primary hyperparathyroidism?
Parathyroidectomy in patients with primary hyperparathyroidism is associated with a significant reduction in large artery stiffness (pulse wave velocity) at 6 months, though it does not alter short-term renal microvascular resistance.
Absolute Event Rate: 0% vs 0%
Abstract Context Primary hyperparathyroidism (PHPT), characterized by elevated parathyroid hormone (PTH) and hypercalcemia, has been implicated in vascular calcification and increased arterial stiffness. Carotid-femoral pulse wave velocity (PWV) is the gold-standard marker of large artery stiffness, while the Augmentation Index (AI), pulse pressure (PP), and Renal Resistive Index (RRI) offer insights into wave reflection and microvascular function. Objective This study aimed to assess the associations between PTH levels and these vascular parameters before and after parathyroidectomy (PTX). Methods In a prospective, monocentric cohort study, PHPT patients undergoing elective PTX had vascular assessments at baseline and 6 months postoperatively. Associations between PTH and vascular markers (PWV, AI, PP, and RRI) were evaluated using Pearson correlations, linear regression, and multivariable mixed-effects regression models adjusted for cardiovascular and metabolic covariates. Results Among 107 patients (80% women, median age 64 years), PTH and PWV significantly declined 6 months after PTX, whereas AI, PP, and RRI remained unchanged. In adjusted models, higher PTH was independently associated with increased PWV (β = .10; 95% CI, 0.02-0.18). No statistically significant associations were observed between PTH and AI or PP. At baseline, PTH levels were positively associated with RRI (β = 2.16; 95% CI, 0.19-4.13), but this association did not persist after PTX. Conclusion Elevated PTH is independently associated with greater large artery stiffness in PHPT, and this effect appears to be at least partially reversible following PTX. However, changes in PTH were not associated with short-term changes in renal microvascular resistance, suggesting a delayed or less reversible effect on renal vasculature.
Huber et al. (Mon,) reported a other. Parathyroidectomy reduced PTH levels and significantly declined pulse wave velocity by 10% (β = .10; 95% CI, 0.02-0.18), indicating improved large artery stiffness.