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Serum calcium and the ECG in patients with primary hyperparathyroidism
1Department of Internal Medicine, University Hospital, Uppsala, Sweden.
Insights
Primary hyperparathyroidism (HPT) affects electrocardiograms, showing shorter ST-segments and prolonged T waves. These changes correlate with serum calcium levels, indicating potential cardiovascular impacts.
Area of Science:
- Cardiology
- Endocrinology
Background:
- Primary hyperparathyroidism (HPT) is linked to cardiovascular disease.
- Systematic studies on electrocardiographic (ECG) findings in HPT are lacking.
Purpose of the Study:
- To investigate the electrocardiographic findings in patients with primary hyperparathyroidism.
- To determine the correlation between serum calcium levels and ECG parameters in HPT.
Main Methods:
- Analysis of preoperative electrocardiograms from 139 primary HPT patients and 97 control subjects.
- Multiple regression analysis to account for age, sex, and blood pressure.
Main Results:
- Serum calcium levels significantly correlated with QRS amplitude, ST-segment duration, QT interval, and T wave duration.
- HPT patients exhibited shorter ST-segment duration and increased QRS amplitude compared to controls.
- A significant prolongation of the T wave duration was observed in HPT patients.
Conclusions:
- Electrocardiograms in primary hyperparathyroidism show distinct alterations, including changes in QRS amplitude, ST-segment, QT interval, and T wave duration.
- These ECG changes are significantly correlated with serum calcium levels, even after adjusting for confounding factors.
- Further evaluation of the hemodynamic effects of these electrocardiographic findings in HPT is warranted.
Abstract:
Primary hyperparathyroidism (HPT) is associated with cardiovascular disease, but there are no systematic studies on the electrocardiographic findings in HPT. Preoperative electrocardiograms from 139 patients with primary HPT and 97 control patients were therefore investigated. Serum calcium levels were found to be significantly correlated to the QRS amplitude (r = .26, P < .002), ST-segment duration (r = -.55, P < .0001), QT interval (r = -.64, P < .0001), and T wave duration (r = .19, P < .009). These relations were still significant when the influence of age, sex, and blood pressure level were taken into account in the multiple regression analysis. Thus, the electrocardiograms from HPT patients, compared to normocalcemic control patients, showed a shorter duration of the ST-segment, representing the systolic interval, and an increased amplitude of the QRS complex, representing ventricular muscle mass. Furthermore, the duration of the T wave was significantly prolonged in HPT patients. The hemodynamic effects of these findings have to be further evaluated.