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Increased plasma concentrations of N-terminal pro-B-type natriuretic peptide in patients with mild primary hyperparathyroidism

Almqvist, Erik LU ; Becker, Charlotte LU ; Bondeson, Anne-Greth LU ; Bondeson, Lennart LU ; Svensson, Johan and Svensson, Sven-Eric (2006) In Clinical Endocrinology 65(6). p.760-766
Abstract
Objective Primary hyperparathyroidism (PHPT) is associated with heart disease. The aims of the present study were to evaluate how cardiac function and secretion of N-terminal pro-B-type natriuretic peptide (NT-proBNP) correlate in patients with mild PHPT, and how the plasma level of NT-proBNP is influenced by cure of the parathyroid disease. Design and patients Forty-two patients with PHPT without symptoms of heart disease were examined before and 1 year after curative parathyroidectomy. Measurements Plasma or serum concentrations of NT-proBNP, calcium, PTH, creatinine, oestradiol, testosterone and SHBG were measured. Cardiac function was evaluated by equilibrium radionuclide angiography (ERNA). Results At baseline, NT-proBNP levels... (More)
Objective Primary hyperparathyroidism (PHPT) is associated with heart disease. The aims of the present study were to evaluate how cardiac function and secretion of N-terminal pro-B-type natriuretic peptide (NT-proBNP) correlate in patients with mild PHPT, and how the plasma level of NT-proBNP is influenced by cure of the parathyroid disease. Design and patients Forty-two patients with PHPT without symptoms of heart disease were examined before and 1 year after curative parathyroidectomy. Measurements Plasma or serum concentrations of NT-proBNP, calcium, PTH, creatinine, oestradiol, testosterone and SHBG were measured. Cardiac function was evaluated by equilibrium radionuclide angiography (ERNA). Results At baseline, NT-proBNP levels correlated negatively with systolic function [left ventricular ejection fraction (LVEF), P < 0.001]. Twelve per cent of the patients had NT-proBNP levels above normal reference values preoperatively. One year postoperatively, the corresponding proportion was 21%. The mean plasma concentration of NT-proBNP increased after parathyroidectomy (P < 0.01) in parallel with a dip in diastolic function (peak filling rate, P < 0.05) and a falling trend in systolic function (LVEF, P = 0.08). The postoperative percentage changes in circulating NT-proBNP and total oestradiol correlated positively (P < 0.05). Conclusions Patients with mild PHPT and normal renal function may have high levels of circulating NT-proBNP despite the absence of symptomatic heart disease. Cure of the parathyroid disease is followed by a further increase in NT-proBNP secretion in parallel with ERNA measures, indicating subclinical changes in heart function. These results are in line with data indicating an association between PHPT and increased risk of premature death. (Less)
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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Clinical Endocrinology
volume
65
issue
6
pages
760 - 766
publisher
Wiley-Blackwell
external identifiers
  • wos:000242111400010
  • scopus:33751074669
ISSN
1365-2265
DOI
10.1111/j.1365-2265.2006.02663.x
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Surgery (013242200), Clinical Chemistry, Malmö (013016000), Pathology (Malmö) (013031000), Emergency medicine/Medicine/Surgery (013240200), Surgery Research Unit (013242220)
id
2d4cb214-bb19-46c7-a787-32e06511e572 (old id 685792)
date added to LUP
2016-04-01 12:22:18
date last changed
2022-01-27 02:48:43
@article{2d4cb214-bb19-46c7-a787-32e06511e572,
  abstract     = {{Objective Primary hyperparathyroidism (PHPT) is associated with heart disease. The aims of the present study were to evaluate how cardiac function and secretion of N-terminal pro-B-type natriuretic peptide (NT-proBNP) correlate in patients with mild PHPT, and how the plasma level of NT-proBNP is influenced by cure of the parathyroid disease. Design and patients Forty-two patients with PHPT without symptoms of heart disease were examined before and 1 year after curative parathyroidectomy. Measurements Plasma or serum concentrations of NT-proBNP, calcium, PTH, creatinine, oestradiol, testosterone and SHBG were measured. Cardiac function was evaluated by equilibrium radionuclide angiography (ERNA). Results At baseline, NT-proBNP levels correlated negatively with systolic function [left ventricular ejection fraction (LVEF), P &lt; 0.001]. Twelve per cent of the patients had NT-proBNP levels above normal reference values preoperatively. One year postoperatively, the corresponding proportion was 21%. The mean plasma concentration of NT-proBNP increased after parathyroidectomy (P &lt; 0.01) in parallel with a dip in diastolic function (peak filling rate, P &lt; 0.05) and a falling trend in systolic function (LVEF, P = 0.08). The postoperative percentage changes in circulating NT-proBNP and total oestradiol correlated positively (P &lt; 0.05). Conclusions Patients with mild PHPT and normal renal function may have high levels of circulating NT-proBNP despite the absence of symptomatic heart disease. Cure of the parathyroid disease is followed by a further increase in NT-proBNP secretion in parallel with ERNA measures, indicating subclinical changes in heart function. These results are in line with data indicating an association between PHPT and increased risk of premature death.}},
  author       = {{Almqvist, Erik and Becker, Charlotte and Bondeson, Anne-Greth and Bondeson, Lennart and Svensson, Johan and Svensson, Sven-Eric}},
  issn         = {{1365-2265}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{760--766}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Clinical Endocrinology}},
  title        = {{Increased plasma concentrations of N-terminal pro-B-type natriuretic peptide in patients with mild primary hyperparathyroidism}},
  url          = {{http://dx.doi.org/10.1111/j.1365-2265.2006.02663.x}},
  doi          = {{10.1111/j.1365-2265.2006.02663.x}},
  volume       = {{65}},
  year         = {{2006}},
}