Reversible changes of electrocardiographic abnormalities after parathyroidectomy in patients with primary hyperparathyroidism.
BACKGROUND
Several studies have reported that primary hyperparathyroidism is a risk factor of higher cardiovascular mortality, mainly because hyperparathyroidism is related to arterial hypertension, arrhythmias, structural heart abnormalities and activation of the renin-angiotensin- aldosterone system. However, very few studies have shown the electrocardiographic changes that occur after parathyroidectomy. That was the aim of this study.


METHODS
We studied 57 consecutive patients with primary hyperparathyroidism surgically treated. Electrocardiogram, serum electrolytes, parathyroid hormone, creatinine and albumin measures were obtained before and after surgery and were compared.


RESULTS
The most common basal electrocardiographic abnormalities were left ventricular hypertrophy (LVH, 24.6%), conduction disturbances (16.3%), and short QT and QTc intervals. After surgery, a QTc interval lengthening and a tendency of T wave shortening were observed, as well as an inverse association between QTc interval and serum levels of magnesium and corrected calcium. There were no differences in LVH and conduction disturbances after surgery.


CONCLUSIONS
Primary hyperparathyroidism is an important factor in the development of electrocardiographic abnormalities in this population, some of which are not corrected after parathyroidectomy. Further studies are required to demonstrate what factors are associated with persistence of electrocardiographic disturbances after surgery.
Heart Failure Clinic at Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México.
Oscar
O
Vázquez-Díaz
Lilia
L
Castillo-Martínez
Arturo
A
Orea-Tejeda
Juan José
JJ
Orozco-Gutiérrez
Enrique
E
Asensio-Lafuente
Alfredo
A
Reza-Albarrán
Rubén
R
Silva-Tinoco
Verónica
V
Rebollar-González
D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000209:etiology* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D004573:Electrolytes / Q000097:blood; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D017379:Hypertrophy, Left Ventricular / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy; D012709:Serum Albumin / Q000378:metabolism; D016896:Treatment Outcome
D015415:Biomarkers; D004573:Electrolytes; D010281:Parathyroid Hormone; D012709:Serum Albumin; D003404:Creatinine