title: Cardiac structure and functions in patients with asymptomatic primary hyperparathyroidism.
abstract: BACKGROUND
  The data about cardiovascular (CV) changes in patients with asymptomatic primary hyperparathyroidism (PHPT) are scarce.
  
  
  OBJECTIVE
  The aim of this study is to compare cardiac structure and functions in patients with asymptomatic PHPT and controls by using tissue Doppler echocardiography.
  
  
  METHODS
  Thirty-eight patients with asymptomatic PHPT and 31 sex- and age-matched controls with similar cardiac risk factors were evaluated.
  
  
  RESULTS
  There was no significant difference in ejection fraction (EF) between the patients and the controls [64±5.95 vs 62±3.25% (p=0.094)]. Left ventricular mass index (LVMI) was significantly higher in patients than controls [105.96 (66.45-167.24) vs 93.79 (64.25- 139.25) g/m2, p=0.014]. There was a significant correlation between LVMI and serum calcium (Ca) (r=0.240, p<0.005). Myocardial performance index (MPI) was significantly higher in patients than controls [0.49 (0.35-0.60) vs 0.39 (0.33-0.62), p<0.001]. There was positive correlation between theMPI and serumCa levels (r=0.505, p<0.001), parathyroid hormone (PTH) levels (r=0.464, p<0.001) and LVMI (r=0.270, p<0.005). When the normotensive patients and controls were evaluated, the difference between the groups remained statistically significant considering LVMI and MPI [109 (66.45-167.24) g/m2 vs 94.17 (64.25-75.10) g/m2, p=0.03; and 0.49 (0.35-0.60) vs 0.39 (0.33-0.62), p<0.01, respectively]. There were significant correlations between MPI and Ca (r=0.566, p<0.001), and PTH (r=0.472, p<0.001).
  
  
  CONCLUSIONS
  Our study results showed that cardiacmorphology and diastolic functions are altered in the patients with asymptomatic PHPT. High serum PTH and Ca levels may have an impact on these CV changes. Whether these subtle CV changes would affect cardiac systolic functions and mortality in patients with asymptomatic PHPT should be investigated in further prospective studies.
authors.affiliation: Department of Endocrinology and Metabolism, Gazi University School of Medicine, Ankara, Turkey. baktasyilmaz@yahoo.com.
authors.forename: B
authors.initials: B
authors.lastname: Aktas Yılmaz
authors.forename: A
authors.initials: A
authors.lastname: Akyel
authors.forename: E
authors.initials: E
authors.lastname: Kan
authors.forename: U
authors.initials: U
authors.lastname: Ercin
authors.forename: Y
authors.initials: Y
authors.lastname: Tavil
authors.forename: A
authors.initials: A
authors.lastname: Bilgihan
authors.forename: N
authors.initials: N
authors.lastname: Cakır
authors.forename: M
authors.initials: M
authors.lastname: Arslan
authors.forename: F
authors.initials: F
authors.lastname: Balos Toruner
mesh_terms: D001794:Blood Pressure; D016022:Case-Control Studies; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000033:anatomy & histology* / Q000503:physiopathology*; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D017379:Hypertrophy, Left Ventricular / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000378:metabolism; D016105:Parathyroidectomy; D011379:Prognosis; D012307:Risk Factors
chemical_list: D010281:Parathyroid Hormone