title: Cardiac function in mild primary hyperparathyroidism and the outcome after parathyroidectomy.
abstract: OBJECTIVE
  Primary hyperparathyroidism (PHPT) is associated with cardiovascular morbidity. The extent of cardiovascular abnormalities in patients with mild-asymptomatic disease is unclear. Using sensitive echocardiographic methods, we compared cardiac structure and function in patients with mild PHPT and in healthy controls, and evaluated the changes after parathyroidectomy (PTX).
  
  
  METHODS
  In a prospective case-control design, we studied 51 PHPT patients without any cardiovascular risk factors/diseases and 51 healthy matched controls. Cardiac structure, and systolic and diastolic function were evaluated by echocardiography and Doppler tissue imaging (DTI). Blood pressure (BP) and heart rate were measured.
  
  
  RESULTS
  We observed no differences in systolic or diastolic function or in cardiac morphology between the PHPT patients and the age-matched healthy controls. The regional peak systolic myocardial velocities (S') measured with DTI decreased at all sites (P<0.05) after PTX (tricuspid annulus 14.23+/-1.85 to 13.48+/-1.79, septal 8.48+/-0.96 to 7.97+/-0.85, and lateral 9.61+/-2.05 to 8.87+/-1.63 cm/s, part of the mitral annulus). At baseline, systolic BP was higher in patients compared to controls (127.6+/-17.1 vs 119.6+/-12.6 mmHg, P<0.05). After PTX, both systolic (127.6+/-17.1 vs 124.6+/-16.6 mmHg, P<0.05) and diastolic (80.3+/-9.6 vs 78.4+/-8.6 mmHg, P<0.05) BP decreased.
  
  
  CONCLUSIONS
  Our results indicate that patients with PHPT without cardiovascular risk factors have a normal global systolic and diastolic function and cardiac morphology. BP and the systolic velocities were marginally reduced after PTX, but reflected the values of the control group. Our findings warrant further investigation of the clinical and prognostic significance of these possibly disease-related inotropic effects.
authors.affiliation: Section of Surgery, Department of Clinical Science and Education, Karolinska Institutet Södersjukhuset, S-118 83 Stockholm, Sweden. parastou.farahnak@ki.se
authors.forename: P
authors.initials: P
authors.lastname: Farahnak
authors.forename: M
authors.initials: M
authors.lastname: Ring
authors.forename: K
authors.initials: K
authors.lastname: Caidahl
authors.forename: L-O
authors.initials: LO
authors.lastname: Farnebo
authors.forename: M J
authors.initials: MJ
authors.lastname: Eriksson
authors.forename: I-L
authors.initials: IL
authors.lastname: Nilsson
mesh_terms: D001794:Blood Pressure / Q000502:physiology*; D016022:Case-Control Studies; D005260:Female; D006334:Heart Function Tests / Q000379:methods; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000503:physiopathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy; D011446:Prospective Studies; D016896:Treatment Outcome