Parathyroid hormone is associated with heart failure with preserved ejection fraction

Parathyroid hormone (PTH) is a novel promising biomarker that can predict hospitalization, functional status and mortality in patients who suffered heart failure with preserved ejection fraction (HFpEF).

We aimed to investigate the association of serum PTH levels and measures of disease severity (NYHA functional class, NT-proBNP, CRP, EF, Troponin I) in patients with HFpEF.

A total of consecutive 58 outpatients with HFpEF and 30 controls were prospectively studied. All patients underwent laboratory tests, including NT-proBNP and PTH analyses.

PTH, NT-proBNP, troponin I, and CRP levels were significantly higher in patients with HFpEF when compared with control group (54.61 ± 31.02 vs 40.40 ± 14.22 pg/ml, p < 0.05; 126.05 ± 162.94 vs 44.57 ± 14.95 pg/ml, p < 0.01; 0.011 ± 0.013 vs 0.004 ± 0.001 ug/L, p < 0.01; 4.65 ± 4.24 vs 1.63 ± 0.97 mg/L, p < 0.01, respectively). Left atrium was found to be more enlarged in HFpEF patients (LAVI = 36 ± 18 vs 28 ± 11 ml/m², p < 0.01). Most indices of left ventricular diastolic function were more severely impaired compared to controls (p < 0.05). There was no correlation between PTH and CRP, troponin I, LVMI, LV volumes, LV diameters, E/E', age, and BMI in both groups (p = NS). There was strong positive correlation between PTH and NT-proBNP levels in all study participants (r = 0.359; p < 0.01).

PTH together with other markers of heart failure may provide valuable information both in the diagnosis and staging of heart failure syndromes (Tab. 4, Fig. 1, Ref. 40).