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Parathyroid hormone and left ventricular hypertrophy.

F N Saleh¹, H Schirmer, J Sundsfjord

¹Department of Internal Medicine, University Hospital of North Norway, Tromsø, Norway. farahnez.saleh@unn.no

European Heart Journal

|November 14, 2003

Summary

Elevated parathyroid hormone (PTH) levels predict left ventricular hypertrophy (LVH) in older adults. This association is significant only at substantially high PTH levels, suggesting a role in cardiac pathophysiology.

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Area of Science:

Cardiology
Endocrinology
Nephrology

Background:

A link between parathyroid hormone (PTH) and left ventricular hypertrophy (LVH) is known in end-stage renal disease patients.
In vitro studies suggest PTH can directly promote cardiomyocyte hypertrophy.

Purpose of the Study:

To investigate the relationship between PTH levels and LVH in the general population.
To determine if PTH is an independent predictor of LVH.

Main Methods:

Utilized data from the fourth Tromsø study (1994-1995) including 2700 subjects with serum PTH measurements.
Left ventricular mass by height (LVMH) was estimated using M-mode echocardiography.
Multiple linear regression analysis was employed, controlling for age, BMI, and systolic blood pressure.

Main Results:

In males over 59 and females under 60, PTH was a significant positive predictor of LVMH (P<0.05).
A non-linear relationship was observed, with a sharp increase in LVMH at the 95th percentile (men) and 98th percentile (women) of PTH.
Subjects in the highest PTH ranges showed 12-17% greater adjusted LVMH compared to those in the lowest 10%.

Conclusions:

Parathyroid hormone (PTH) is an independent predictor of left ventricular hypertrophy (LVH) in specific age groups of the general population.
The association between PTH and LVH is evident only at substantially elevated PTH levels.
These findings suggest a potential role for high PTH in cardiac pathophysiology.