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[The cardiovascular manifestations of Paget's disease]
Insights
This study on Paget's disease found frequent, often latent, cardiac issues like conduction and repolarization disorders. Calcitonin showed promise in treating these cardiovascular manifestations.
Area of Science:
- Cardiology
- Endocrinology
- Rheumatology
Background:
- Paget's disease of bone is a chronic disorder affecting bone remodeling.
- Previous hypotheses on cardiovascular involvement include peripheral syndrome and vascular calcification.
- Cardiac manifestations in Paget's disease are often underdiagnosed due to latency.
Purpose of the Study:
- To investigate the prevalence and characteristics of cardiac manifestations in patients with Paget's disease.
- To analyze electrocardiographic findings in relation to patient and disease parameters.
- To explore potential therapeutic strategies for cardiac involvement.
Main Methods:
- Retrospective analysis of 150 patients with Paget's disease followed over several years.
- Systematic cardiac evaluation using electrocardiography (ECG).
- Correlation of ECG findings with patient demographics (age, sex) and disease characteristics (evolution, diffusion).
Main Results:
- 91 out of 150 patients exhibited ECG disturbances.
- Conduction disorders were observed in 43 cases, and repolarization disorders in 48 cases.
- Cardiac issues were more frequent during evolutive stages of Paget's disease.
Conclusions:
- Cardiac manifestations are common and often latent in Paget's disease, necessitating systematic ECG monitoring.
- Understanding the distribution of ECG disorders aids in patient stratification.
- Calcitonin demonstrated anti-arrhythmic potential and positive therapeutic effects in preliminary observations.
Abstract:
After reviewing the old ideas (peripheral syndrome and cardiac insufficiency at high outputs) and more recent ideas (arterial and intracardiac vascular calcification), the authors report their experiences based on the study of the histories of 150 patients suffering from Paget's disease followed for several years. First they emphasize the frequent latency of cardiac manifestations looked for systematically by means of the electrocardiogram particularly during evolutive stages of the disease. Electrocardiographic disturbances were observed 91 times and included 43 cases of conduction disorders and 48 of repolarization disorders; their distribution was studied as a function of various inherent parameters, of the patient (age and sex) and of the disease (its evolutive character and its degree of diffusion). On the basis of the anti-arythmic power of calcitonin found during experiments and obtained excellent results three times. Finally the place of cardiovascular manifestations in the pathogenic hypotheses and nosology of Paget's disease is discussed.