Left ventricular structure and function in primary hyperparathyroidism before and after parathyroidectomy

Objective: Our aim was to study the effect of primary hyperparathyroidism ( PHPT) and parathyroidectomy (PTX) on left ventricular (LV) wall thicknesses and systolic and diastolic function. Methods: Fifteen patients with untrea ted PHPT were evaluated by applying Doppler and digitized M-mode echocardio graphy before and 2-3 months after PTX, Fifteen age- and sex-matched health y controls were also examined echocardiographically. Results: Prior to PTX, interventricular septal thickness (IVST), LV mass (LVM), aortic root dimen sion and left atrium dimension were greater and LV fractional shortening wa s slightly decreased in patients as compared to controls. Significantly inc reased LV peak late diastolic velocity (A,,,) and isovolumic relaxation tim e, and a slightly decreased ratio of peak early to peak late diastolic velo cities (EIA,,,) in the patients indicated impairment of LV diastolic functi on in hyperparathyroidism. PTX reduced serum total Ca from 2.79 +/- 0.13 to 2.39 +/- 0.09 mmol/l (p < 0.001) and tended to reduce IVST [10.6 +/- 2.1 v s. 10.4 +/- 2.0 mm; not significant (n.s.)], LV posterior wall thickness (9 .6 +/- 2.0 vs. 9.2 +/- 1.0 mm, n.s.) and LVM (250 +/- 102 vs. 213 +/- 42 g; n.s,). Before PTX, there was a significant correlation between serum total Ca and LVM (r = 0.63, p < 0.05), and the PTX-induced change in serum total calcium correlated with the change in LVM (r = 0.59, p < 0.05). PTX induce d no significant changes in LV systolic or diastolic function during the fo llow-up of 2-3 months. Conclusions: The present findings indicate that PHPT induces LV hypertrophy, slight impairment of LV systolic function and sign ificant impairment of LV diastolic function, which are not substantially im proved after TX and 2-3 months of normocalcemia, Copyright (C) 2000 S. Karg er AG, Basel.