title: Interrelationship between haemodynamic state and serum intact parathyroid hormone levels in patients with chronic heart failure.
abstract: OBJECTIVE
  To assess the impact of serum intact parathyroid hormone (PTH) levels on haemodynamic state and their relations by comparing plasma B-type natriuretic peptide (BNP) levels.
  
  
  METHODS
  Cross-sectional study in molecular epidemiology.
  
  
  METHODS
  Mie University Hospital, Tsu, Japan.
  
  
  METHODS
  Consecutive 105 patients with chronic heart failure (CHF).
  
  
  METHODS
  Serum intact PTH and plasma BNP levels were assessed simultaneously with right heart catheterisation.
  
  
  RESULTS
  Although serum intact PTH levels (46±25 pg/ml) were within the normal range (<65 pg/ml) in 87% of patients, log-transformed intact PTH levels signiﬁcantly correlated with pulmonary capillary wedge pressure (PCWP: 15±9 mm Hg, r=0.55, p<0.05) and heart rate (73±14/min, r=0.40, p<0.05), whereas log-transformed intact PTH levels were inversely correlated with stroke volume index (SVI: 38±11 ml/m(2), r=-0.52, p<0.05) and cardiac index (2.6±0.7 l/min/m(2), r=-0.41, p<0.05) in all patients. PCWP and SVI were independent determinants of log-transformed intact PTH levels (β=0.40 and -0.37, p<0.05, respectively) after adjusting for variables associated with PTH. Conversely, after adjusting for variables associated with CHF, log-transformed intact PTH levels were an independent determinant of PCWP, SVI, heart rate and cardiac index (β=0.38, -0.33, 0.32, and -0.25, p<0.05, respectively), and might be defined as a superior determinant of SVI and cardiac index compared with log-transformed BNP levels using stepwise multivariate regression analyses.
  
  
  CONCLUSIONS
  Increased PCWP and decreased SVI independently contribute to elevated intact PTH in patients with CHF.
authors.affiliation: Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Japan. t_sugimoto_japan@hotmail.com
authors.forename: Tadafumi
authors.initials: T
authors.lastname: Sugimoto
authors.forename: Kaoru
authors.initials: K
authors.lastname: Dohi
authors.forename: Katsuya
authors.initials: K
authors.lastname: Onishi
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Watanabe
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Sato
authors.forename: Emiyo
authors.initials: E
authors.lastname: Sugiura
authors.forename: Shiro
authors.initials: S
authors.lastname: Nakamori
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakajima
authors.forename: Mashio
authors.initials: M
authors.lastname: Nakamura
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ito
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D006328:Cardiac Catheterization; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010281:Parathyroid Hormone / Q000097:blood*; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends
chemical_list: D015415:Biomarkers; D010281:Parathyroid Hormone; D020097:Natriuretic Peptide, Brain