The relationship between primary hyperparathyroidism and frontal QRS-T angle

Primary hyperparathyroidism (PHPT) is characterized by hypercalcemia due to elevated parathyroid hormone (PTH) levels. It has long been established that cardiac contraction and relaxation are primarily the result of recurrent phasic increases and decreases in cytoplasmic calcium ion concentration. Calcium balance plays a crucial role in ventricular repolarization and depolarization. This study aimed to investigate whether there is a relationship between the frontal QRS-T angle and newly diagnosed PHPT patients.

This study was designed as a prospective cross-sectional study. A total of 142 individuals were included, comprising 71 patients over the age of 18 who consented to participate and 71 healthy volunteers. Patients under the age of 18, those who declined to participate, and those with chronic kidney disease, heart failure, pericardial effusion, or undergoing oncological follow-up for malignancy were excluded from the study.

In the patient group, the mean systolic blood pressure was 132 mm-Hg, and the mean diastolic blood pressure was 77.8 mm-Hg. These values were statistically significantly higher compared to the control group (p < 0.001). The mean frontal QRS-T angle on the ECG was -9.0° in the patient group and 2.0° in the control group. It was found that the frontal QRS-T angle in the patient group had wider angle values compared to the control group. This difference was considered statistically weakly significant (p < 0.001).

The frontal QRS-T angle in newly diagnosed PHPT patients differs from that in healthy individuals. We believe that the increase in this angle, calculated from the electrocardiogram obtained at the time of diagnosis, could serve as a warning parameter for clinicians in terms of the risk of cardiovascular complications.