Abstract
Background. Nontraditional manifestations of primary hyperparathyroidism (HPT) are controversial
and may include morbidity, mortality, and risk factors for cardiovascular diseases.
This study evaluates cardiovascular functions at rest and during exercise in HPT.
Method. Thirty patients with HPT (mean serum calcium, 2.97 ± 0.24 mmol/L) and 30 control
people with normocalcemia, matched for age and sex, underwent symptom-limited exercise
testing and echocardiography before and 13 months (mean) after having a parathyroidectomy.
Results. Despite similar maximal workload and blood pressures at rest in patients and healthy
controls, HPT associated with higher systolic blood pressure during exercise (P =.03) and increased number of ventricular extrasystolic beats (P =.04). There was also an operatively reversible increase in ST-segment depression
during exercise. Echocardiography showed an increased left ventricular (LV) isovolemic
relaxation time (P =.02) and mitral deceleration time (P =.08), which indicate an LV diastolic dysfunction that could be partially reversed
by operation. LV systolic function (ejection fraction and shortening fraction) tended
to be elevated in HPT (P =.07 and.06, respectively) and diminished after parathyroidectomy. There was a trend
toward higher LV mass, especially among the men with HPT (P =.06), which was unchanged postoperatively. Conclusions. HPT couples to reversible signs of myocardial ischemia and LV dysfunctions with a
possible increased risk of life-threatening arrhythmia. (Surgery 2000;128:895-902.)
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Article info
Footnotes
*Supported by the Swedish Medical Research Council.
**Reprint requests: Inga-Lena Nilsson, MD, Department of Surgery, Sundsvall Hospital, S-851 86 Sundsvall, Sweden.
★Surgery 2000;128:895-902.
Identification
Copyright
© 2000 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
