Assessment of Cardiovascular System Abnormalities in Patients with Advanced Primary Hyperparathyroidism by Detailed Echocardiographic Analysis: A Prospective Study
SK Mishra, Amit Agarwal, Anand K Mishra,, Sudeep Kumar,
Citation Information :
Mishra S, Agarwal A, Mishra, AK, Kumar, S. Assessment of Cardiovascular System Abnormalities in Patients with Advanced Primary Hyperparathyroidism by Detailed Echocardiographic Analysis: A Prospective Study. World J Endoc Surg 2017; 9 (2):46-50.
Recognizing the paucity of data regarding the incidence of cardiovascular abnormalities in severe primary hyperparathyroidism (PHPT), a prospective study was done for left ventricular (LV) systolic and diastolic function by echocardiography in patients with hyperparathyroidism (HPT) before surgery.
Materials and methods
A total of 18 consecutive patients with HPT and an equal number of age- and sex-matched controls were studied by two-dimensional and Doppler echocardiography.
Results
Patients with HPT had higher systolic and diastolic blood pressures (BPs). Despite severe bone disease, nephropathy, and vitamin D deficiency, none had metastatic calcification in myocardium. There was no significant increase in LV systolic dimensions and volume, but decreased ejection fraction (EF) and significant diastolic dysfunction were observed.
Conclusion
Despite an asymptomatic cardiac status, there were decreased EF and significant diastolic dysfunction. The HPT patients despite having severe disease, did not have metastatic calcification.
How to cite this article
Mishra AK, Agarwal A, Kumar S, Mishra SK. Assessment of Cardiovascular System Abnormalities in Patients with Advanced Primary Hyperparathyroidism by Detailed Echocardiographic Analysis: A Prospective Study. World J Endoc Surg 2017;9(2):46-50.
Causes of death in patients previously operated on for primary hyperparathyroidism. Ann Chir Gynaecol 1985;74(1):13-18.
Mortality after surgery for primary hyperparathyroidism: a follow-up of 441 patients operated on from 1956 to 1979. Surgery 1987 Jul;102(1):1-7.
Premature death in patients operated on for primary hyperparathyroidism. World J Surg 1990 Nov-Dec;14(6):829-835.
Hypertension and primary hyperparathyroidism: the role of adrenergic and renin-angiotensin-aldosterone systems. Miner Electrolyte Metab 1995 Feb;21(1-3):77-81.
Blood pressure, left ventricular mass and intracellular calcium in primary hyperparathyroidism. Clin Sci (Lond) 1990 Feb;78(2):127-132.
Cardiac abnormalities in patients with primary hyperparathyroidism: implications for follow-up. J Clin Endocrinol Metab 1997 Jan;82(1):106-112.
Cardiac calcific deposits in patients with primary hyperparathyroidism: preliminary results of a prospective echocardiographic study. Surgery 1990 Dec;108(6):1052-1056.
Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 1992 Nov;340(8828):1111-1115.
Nitric oxide is responsible for flow-dependent dilation of human peripheral conduit arteries in vivo. Circulation 1995 Mar;91(5):1314-1319.
Effect of chronic and subacute parathyroidectomy on blood pressure and resistance artery contractility in the spontaneously hypertensive rat. J Hypertens 1993 Jul;11(7):709-716.
Defective nitric oxide synthesis. A link between metabolic insulin resistance, sympathetic overactivity and cardiovascular morbidity. Eur J Endocrinol 2000 Apr;142(4):315-323.
Evaluation and management of primary hyperparathyroidism – author’s response. J Clin Endocrinol Metab 1997 Mar;82(3):983.
Unique clinical characteristics of primary hyperparathyroidism in India. Br J Surg 2001 May;88(5):708-714.
Prognostic imolications of echocardiographically determined left ventricular mass in the Framingham Heart study. N Eng J Med 1990 May;322(22):1561-1566.
Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension. Ann Inter Med 1991 Mar;114(5):345-352.
The heart in hypertension. N Eng J Med 1992 Oct;327(14):998-1008.
The prognostic role of left ventricular hypertrophy in patients with or without coronary artery disease. Ann Intern Med 1992 Nov;117(10):831-836.
Augmentation of central arterial pressure in mild hyperparathyroidism. J Clin Endocrinol Metab 2000 Oct;85(10):3515-3519.
Arterial stiffness: a anew cardiovascular risk factor. Am J Epidemiology 1994 Oct;140(8):669-682.
Cardiac hypertrophy, hypertrophic cardiomyopathy, and hyperparathyroidism- an association. Br Heart J 1985 Nov;54(5):539-542.
Mild primary hyperparathyroidism: Vitamin D deficiency and Cardiovascular risk markers. J Clin Endocrinol Metab 2011 Jul;96(7):2112-2118.
Cardiac function in mild primary hyperparathyroidism and the outcome after parathyroidectomy. Eur J Endocrinol 2010 Sep;163(3):461-467.
Effects of successful parathyroidectomy on metabolic CV risk factors in patients with severe primary hyperparathyroidism. Endocr Pract 2011 Jul-Aug;17(4):584-590.