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Cardiac dysfunction in mild primary hyperparathyroidism assessed by radio-nuclide angiography and echocardiography before and after parathyroidectomy

Almqvist, Erik LU ; Bondeson, Anne-Greth LU ; Bondeson, Lennart LU ; Nissborg, A; Smedgard, P and Svensson, S (2002) In Surgery 132(6). p.1126-1132
Abstract
Background.. Primary hyperparathyroidism (PHPT) is associated with increased cardiovascular morbidity for reasons that are incompletely understood. The present study was undertaken to evaluate the effects of parathyroidectomy on cardiac function especially in patients with mild PHPT Methods. Fifty patients with mild PHPT (serum calcium, 2.55 to 2.95 mmol/L) were randomized to parathyroidectomy either directly (group A) or after 1 year of observation (group B). Equilibrium radionuclide angiography (ERNA) at rest and at exercise was performed in addition to echocardiography on all patients at inclusion in the study and 1 and 2 years later. Results. Left ventricular mass index was larger (P <.05) in group B compared with group A after 2... (More)
Background.. Primary hyperparathyroidism (PHPT) is associated with increased cardiovascular morbidity for reasons that are incompletely understood. The present study was undertaken to evaluate the effects of parathyroidectomy on cardiac function especially in patients with mild PHPT Methods. Fifty patients with mild PHPT (serum calcium, 2.55 to 2.95 mmol/L) were randomized to parathyroidectomy either directly (group A) or after 1 year of observation (group B). Equilibrium radionuclide angiography (ERNA) at rest and at exercise was performed in addition to echocardiography on all patients at inclusion in the study and 1 and 2 years later. Results. Left ventricular mass index was larger (P <.05) in group B compared with group A after 2 years and showed significant correlation to the serum concentration of parathyroid hormone (but not Serum calcium) after 1 year. ERNA showed transient subclinical changes in both systolic and diastolic function Parameters after parathyroidectomy (decrease of left ventricular ejection fraction and peak fill-ingrate, with return to preoperative Levels within 1 year). Conclusions. Combined evaluation by ERNA and echocardiography has shown previously unknown aspects of parathyroid/myocardial interaction, which is consistent with an inotropic influence exerted by parathyroid hormone, and is in favor of early surgical treatment for PHPT irrespective of serum calcium levels. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Surgery
volume
132
issue
6
pages
1126 - 1132
publisher
Elsevier
external identifiers
  • pmid:12490865
  • wos:000180123000060
  • scopus:0036915110
ISSN
1532-7361
DOI
10.1067/msy.2002.128692
language
English
LU publication?
yes
id
dd471fac-f448-4aa1-aad3-faf4cda3ac6d (old id 892121)
date added to LUP
2008-01-15 13:08:04
date last changed
2017-12-10 04:28:45
@article{dd471fac-f448-4aa1-aad3-faf4cda3ac6d,
  abstract     = {Background.. Primary hyperparathyroidism (PHPT) is associated with increased cardiovascular morbidity for reasons that are incompletely understood. The present study was undertaken to evaluate the effects of parathyroidectomy on cardiac function especially in patients with mild PHPT Methods. Fifty patients with mild PHPT (serum calcium, 2.55 to 2.95 mmol/L) were randomized to parathyroidectomy either directly (group A) or after 1 year of observation (group B). Equilibrium radionuclide angiography (ERNA) at rest and at exercise was performed in addition to echocardiography on all patients at inclusion in the study and 1 and 2 years later. Results. Left ventricular mass index was larger (P &lt;.05) in group B compared with group A after 2 years and showed significant correlation to the serum concentration of parathyroid hormone (but not Serum calcium) after 1 year. ERNA showed transient subclinical changes in both systolic and diastolic function Parameters after parathyroidectomy (decrease of left ventricular ejection fraction and peak fill-ingrate, with return to preoperative Levels within 1 year). Conclusions. Combined evaluation by ERNA and echocardiography has shown previously unknown aspects of parathyroid/myocardial interaction, which is consistent with an inotropic influence exerted by parathyroid hormone, and is in favor of early surgical treatment for PHPT irrespective of serum calcium levels.},
  author       = {Almqvist, Erik and Bondeson, Anne-Greth and Bondeson, Lennart and Nissborg, A and Smedgard, P and Svensson, S},
  issn         = {1532-7361},
  language     = {eng},
  number       = {6},
  pages        = {1126--1132},
  publisher    = {Elsevier},
  series       = {Surgery},
  title        = {Cardiac dysfunction in mild primary hyperparathyroidism assessed by radio-nuclide angiography and echocardiography before and after parathyroidectomy},
  url          = {http://dx.doi.org/10.1067/msy.2002.128692},
  volume       = {132},
  year         = {2002},
}