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Evaluation of endothelial function and diastolic function in patients with primary hyperparathyroidism before and

Roser M Magriñá-Mercado1, Claudia Ramírez-Rentería2, Eduardo Almeida-Gutiérrez3

  • 1Servicio de Endocrinología. Hospital de Especialidades Centro Médico Nacional Siglo XXI. Ciudad de México, México.

Cirugia Y Cirujanos
|February 16, 2019
PubMed

Insights

Parathyroidectomy improved endothelial function in patients with primary hyperparathyroidism (PHPT). Six months post-surgery, flow-mediated vasodilation (FMV) showed reduced endothelial dysfunction, with a trend toward improved diastolic function.

Area of Science:

  • Cardiovascular physiology
  • Endocrinology
  • Vascular biology

Background:

  • Primary hyperparathyroidism (PHPT) is a key cause of hypercalcemia with elevated cardiovascular risk.
  • Endothelial function, assessed non-invasively by flow-mediated vasodilation (FMV), is crucial for cardiovascular health.

Purpose of the Study:

  • To compare endothelial dysfunction via FMV and diastolic dysfunction in PHPT patients.
  • To evaluate changes before and after parathyroidectomy.

Main Methods:

  • A quasi-experimental before-and-after study design was employed.
  • Diastolic function and FMV were assessed in PHPT patients pre-surgery and 6 months post-surgery.

Main Results:

  • Fifteen patients completed the study; 73% had diastolic dysfunction pre-surgery, decreasing to 60% post-surgery (p=0.09).
  • Brachial artery diameter post-ischemia significantly improved from 41 mm to 46 mm (p=0.020) after parathyroidectomy.
  • The change in brachial diameter (pre- vs. post-ischemia) increased from 1 mm pre-surgery to 4 mm post-surgery (p=0.03).

Conclusions:

  • Surgery for PHPT led to minor improvements in endothelial function (FMV) 6 months post-operation.
  • A trend towards improved diastolic function was observed post-parathyroidectomy.
  • Echocardiography may aid in preoperative assessment for asymptomatic PHPT patients.
Abstract

Keywords:
Endotelio vascularHiperparatiroidismo primarioParathyroidectomyParatiroidectomíaPrimary hyperparathyroidismVascular endotheliumVasodilataciónVasodilation

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