Key result
Asymptomatic primary hyperparathyroidism was associated with greater LV mass (148 vs 127 g, P=0.002) and more moderate to severe LV diastolic filling impairment (36% vs 4%, P<0.001).
Why the study?
Does asymptomatic primary hyperparathyroidism alter left ventricular structure and diastolic performance compared to healthy controls?
Case-Control (n=100)
Does asymptomatic primary hyperparathyroidism alter left ventricular structure and diastolic performance compared to healthy controls?
Absolute Event Rate: 36% vs 4%
p-value: p=<0.001
Asymptomatic primary hyperparathyroidism is associated with adverse left ventricular structural changes and impaired diastolic function.
Should not yet change management of asymptomatic primary hyperparathyroidism; leaves open whether LV changes warrant prospective intervention trials.
Aim: This study aims to investigate cardiac structure and function in patients with asymptomatic primary hyperparathyroidism (pHPT) and if there is any relation to severity regarding serum levels of calcium (Ca) and parathyroid hormone. Methods and Results: We consecutively included 50 patients (mean age 62.9 +/- 11 years, 45 women) with clinically diagnosed pHPT. We prospectively recruited 50 healthy control subjects, matched for age and sex. Standard transthoracic echocardiographic examination was performed using the 4 standard views and structural parameters as well as left ventricular (LV) systolic and diastolic function was determined. Mean LV ejection fraction and atrioventricular plane displacement were on average normal and did not differ between patients and controls. However, pHPT patients had significantly greater LV mass (148 +/- 37 vs. 127 +/- 29 g, P = 0.002), LV end diastolic area (81 +/- 20 vs. 68 +/- 18 cm(2), p = 0.003), LV posterior wall diameter (8.9 +/- 1 vs. 8.1 +/- 1 min, P = 0.006), and LA size (21 +/- 3 vs. 19 +/- 2 mm, P < 0.001). A moderate to severe LV diastolic filling impairment was present in substantially more pHPT patients, compared with control subjects (36% vs. 4%, P < 0:001). Conclusion: Patients with asymptomatic pHPT showed LV structural changes and impaired LV diastolic function.
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Birgander et al. (2009) conducted a case-control in Asymptomatic primary hyperparathyroidism (n=100). Asymptomatic primary hyperparathyroidism vs. Healthy control subjects was evaluated on Moderate to severe LV diastolic filling impairment (p=<0.001). Asymptomatic primary hyperparathyroidism was associated with greater LV mass (148 vs 127 g, P=0.002) and more moderate to severe LV diastolic filling impairment (36% vs 4%, P<0.001).
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