TIME-COURSE OF REGRESSION OF LEFT-VENTRICULAR HYPERTROPHY AFTER SUCCESSFUL PARATHYROIDECTOMY

Background. We have shown that primary hyperparathyroidism may induce myocardial hypertrophy that is reversible after successful parathyroid ectomy. The present study was designed to assess the time course of re gression of left ventricular hypertrophy without further effects of dr ug treatment or disease states. Methods. We performed echocardiographi c studies in 16 patients with primary hyperparathyroidism and normal r esting blood pressure, normal systolic left ventricular function, no e vidence of valvular disease, and without any current medication before parathyroidectomy, as well as during intermediate and long-term follo w-up after successful parathyroidectomy. Results. Eleven patients (69% ) had end-diastolic wall thickness of the interventicular septum and/o r posterior wall greater than 11 mm on baseline echocardiogram. After surgical removal of the inciting disease and an average of 12.5 and 45 .7 months of follow-up with normocalcemia and normal parathyroid hormo ne levels a prolonged regression of left ventricular hypertrophy was o bserved (interventricular septum, -0.68 mm at 12.5 months and -1.69 mm at 45.7 months; p = 0.02; posterior wall, -0.46 mm at 12.5 months and -2.24 mm at 45.7 months; p = 0.02). Conclusions. We conclude that the removal of the cause of myocardial hypertrophy by successful parathyr oidectomy leads to a prolonged reversal of hypertrophy. The progressiv e reduction of left ventricular wall thickness is not completed within 12 months.