PRIMARY HYPERPARATHYROIDISM AND THE HEART - CARDIAC ABNORMALITIES CORRELATED TO CLINICAL AND BIOCHEMICAL DATA

Comparing patients with primary hyperparathyroidism (PHP) to a normoca lcemic control population, those with PHP have a higher incidence of c ardiovascular disease and cardiac abnormalities. This study aimed at c orrelating cardiac findings (valvular and myocardial calcification, my ocardial hypertrophy) with clinical data (age, sex, clinical man ifest ation, nephrolithiasis, nephrocalcinosis, hypertension, skeletal abnor malities, hypercalcemic: syndrome) and biochemical data (serum calcium , serum phosphate, serum iPTH level, serum creatinine). A group of 132 consecutive patients with surgically verified PHP (94 women, 38 men; ages 15-86, mean age 57 +/- 16 years) were included in this study. Blo od chemistry, clinical presentation, radiography, and echocardiography were carried out in all patients for univariate and multivariate anal yses of all parameters. There was no statistical correlation between c linical symptoms, biochemical data, and cardiac calcific alterations. Typical skeletal manifestations (osteolysis/subperiostal resorption) a nd valvular calcifications were significantly correlated to left ventr icular hypertrophy (p = 0.005). Cardiac abnormalities such as calcific myocardial deposits or mitral and aortic valvular calcifications do n ot correlate with laboratory findings and clinical presentation at the time of diagnosis. There was no biochemical or clinical variable that could predict the frequency or severity of valvular sclerosis or calc ific deposits in the myocardium. However, PHP-related skeletal abnorma lities and valvular calcification were predicting. factors for left ve ntricular hypertrophy, a reversible cardiac manifestation of PHP. Myoc ardial hypertrophy is more often found with classic symptomatic PHP wi th osseous abnormalities.