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Cardiac structure and diastolic function in mild primary hyperparathyroidism
M D Walker1, J B Fleischer, M R Di Tullio
1Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.
The Journal of Clinical Endocrinology and Metabolism
|March 16, 2010
Summary
Primary hyperparathyroidism (PHPT) patients with mild disease show normal cardiac structure and diastolic function. However, low vitamin D levels are linked to left ventricular hypertrophy in PHPT.
Area of Science:
- Cardiology
- Endocrinology
- Metabolic Bone Diseases
Background:
- Cardiovascular disease data in primary hyperparathyroidism (PHPT) is conflicting.
- Assessing cardiac structure and diastolic function in mild PHPT is crucial.
Purpose of the Study:
- To evaluate cardiac structure and diastolic function in patients with mild PHPT.
- Compare cardiac parameters in PHPT patients with age- and sex-matched controls.
Main Methods:
- A case-control study involving 54 PHPT patients and 76 controls.
- Measured left ventricular mass index (LVMI), mitral annular calcification, and diastolic function using Doppler tissue imaging (tissue Doppler e').
Main Results:
- PHPT patients exhibited normal LVMI and diastolic function compared to controls.
- No significant difference in LVMI or mitral annular calcification frequency.
- Higher (better) diastolic function variables (E/A, tissue Doppler e') in PHPT patients, within normal ranges.
- Low E/A associated with higher PTH and calcium levels.
- LVMI inversely associated with serum 25-hydroxyvitamin D.
Conclusions:
- Mild PHPT does not show increased left ventricular mass, diastolic dysfunction, or valvular calcifications.
- Low vitamin D levels are associated with left ventricular hypertrophy development in PHPT.
- Disease severity may influence cardiac manifestations in PHPT.
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