Key result
Parathyroidectomy did not significantly change postexercise echocardiographic parameters reflecting cardiac function at 6 months in patients with mild primary hyperparathyroidism.
Why the study?
Does parathyroidectomy improve resting and postexercise cardiac function in patients with mild primary hyperparathyroidism?
Cohort (n=100)
Does parathyroidectomy improve resting and postexercise cardiac function in patients with mild primary hyperparathyroidism?
Parathyroidectomy does not significantly alter postexercise echocardiographic parameters of cardiac function at 6 months in patients with mild primary hyperparathyroidism, although these patients exhibit baseline signs of impaired diastolic function during exercise.
Parathyroidectomy should not yet alter practice for cardiac function in mild primary hyperparathyroidism; leaves open whether longer-term studies detect benefits.
Primary hyperparathyroidism (pHPT) is associated with cardiac disease. This prospective study was designed to investigate changes in cardiac function before and after parathyroidectomy. Resting and post exercise cardiac function was compared with matched control subjects. Fifty patients (mean age 62.9 ± 11 years, 45 women) and 50 healthy control subjects, matched for age and sex were studied. Resting and postmaximum exercise echocardiography/Doppler examination were performed at baseline and 6 months after parathyroidectomy. pHPT patients were tested at baseline and 6 months postoperatively. Control subjects were tested only at baseline. Patients were divided into 4 subgroups based on median preoperative levels of PTH and calcium (Ca): high (↑) PTH/↑ Ca, ↑ PTH/low (↓) Ca, ↑ Ca/↓ PTH, and ↓ PTH/↓ Ca. No significant difference between pHPT patients and control subjects regarding post exercise systolic function were detected. There was a tendency of lowed E/A among pHPT patients which was significant in subgroup ↓PTH/↓Ca (1.07 ± 0.3). Subgroup ↑PTH/↑Ca showed a lower S/D compared with control subjects at baseline (1.28 ± 0.3 vs. 1.48 ± 0.3, P = 0.029). No significant changes regarding post exercise echocardiographic parameters reflecting cardiac function were detected 6 months after parathyriodectomy. Patients with asymptomatic pHPT showed a tendency of elevated filling pressures and signs of impaired diastolic function during exercise.
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Birgander et al. (2009) conducted a cohort in Mild Primary Hyperparathyroidism (n=100). Parathyroidectomy vs. Pre-operative baseline was evaluated on Post exercise echocardiographic parameters reflecting cardiac function. Parathyroidectomy did not significantly change postexercise echocardiographic parameters reflecting cardiac function at 6 months in patients with mild primary hyperparathyroidism.
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