Left ventricular dysfunction in subjects with mild secondary hyperparathyroidism detected with pulsed wave tissue Doppler echocardiography.
OBJECTIVE
To assess left ventricular function by conventional and pulsed wave tissue Doppler (PWTD) echocardiography in subjects with mild secondary hyperparathyroidism, and to evaluate whether PWTD would be more sensitive than conventional echocardiography in detecting subtle changes in LV systolic and diastolic function.


METHODS
In the fifth Tromsø study (2001) serum PTH and calcium were measured in 7,954 subjects. One hundred subjects with secondary hyperparathyroidism (SHPT; serum PTH >6.40 pmol/l and serum calcium <2.40 mmol/l) and 106 control subjects with normal PTH and calcium levels and with no history of cardiovascular disease were examined at the follow-up 6-12 months later.


RESULTS
Conventional transthoracic echocardiography and PWTD of mitral annulus were successfully performed in 83 cases and 88 controls. At follow-up mean serum PTH values were 6.0 +/- 2.2 versus 3.2 +/- 1.3 pmol/l (p < 0.05) and mean calcium 2.28 +/- 0.10 versus 2.33 +/- 0.08 mmol/l (p < 0.05) in cases and controls, respectively. Unpaired t test and multiple linear regression analyses were used. No significant differences in conventional echocardiographic parameters were found. However, PWTD showed reduced systolic velocity in septal, lateral and anterior mitral annulus (p < 0.05) and also reduced early diastolic velocity in septal and anterior mitral annulus (p < 0.05).


CONCLUSIONS
Subjects with mild SHPT have impaired left ventricular long axis function as evaluated by PWTD compared to conventional echocardiography. PWTD seems to be a more sensitive tool in detecting minor changes in left ventricular function and the new modality should routinely be included in studies evaluating left ventricular function, especially the long axis function.
Iqbal
Amjid
A
Department of Cardiology, University Hospital of North Norway, Tromsø, Norway. amjid.iqbal@unn.no
Jorde
Rolf
R
Lunde
Per
P
Sundsfjord
Johan
J
Rasmussen
Knut
K
D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D003971:Diastole; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013318:Stroke Volume; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology