Document Detail

Effect of surgery on cardiac structure and function in mild primary hyperparathyroidism.
MedLine Citation:
PMID:  21044114     Owner:  NLM     Status:  In-Process    
CONTEXT: The cardiovascular (CV) risk profile is worsened in primary hyperparathyroidism (PHPT), and CV mortality is related to serum calcium levels. It is unknown whether CV mortality is increased in the most common form of PHPT and whether the increased CV risk is reversible after surgery.
OBJECTIVE: To investigate reversibility of echocardiographic variables in patients with mild PHPT who were randomized to observation without surgery or operation, and followed for 2 years.
DESIGN/SETTING/PATIENTS: Forty-nine patients (mean age 63 ± 7 years, 8 men) who had performed the 2-year visit in a randomized study on mild PHPT (serum calcium at baseline 2·65 ± 0·09 mm) (observation) vs 2·67 ± 0·06 mm (surgery) and where echocardiography had been performed, participated in the study.
RESULTS: Calcium and parathyroid hormone (PTH) levels were normalized following surgery and were stable in the observation group. PTH levels at baseline were highly correlated with ventricular mass. Detailed echocardiography revealed a minor and borderline significant treatment effect of surgery on left ventricular mass index (LVMI) compared to observation (P = 0·066) and a significant 11% reduction in diastolic dimension of the interventricular septum (IVSd-mean) in the surgery group (P<0·01), with no alterations in the observation group.
CONCLUSIONS: Based on detailed echocardiographic measures over a 2-year observation period, we found only minor differences between the two groups. However, the potential treatment effect on LVMI and the within-group differences in IVSd-mean suggest that longer follow-up may yield larger and clinically important differences.
Anita Persson; Jens Bollerslev; Thord Rosen; Charlotte L Mollerup; Celina Franco; Gunhild A Isaksen; Thor Ueland; Svante Jansson; Kenneth Caidahl;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical endocrinology     Volume:  74     ISSN:  1365-2265     ISO Abbreviation:  Clin. Endocrinol. (Oxf)     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0346653     Medline TA:  Clin Endocrinol (Oxf)     Country:  England    
Other Details:
Languages:  eng     Pagination:  174-80     Citation Subset:  IM    
Copyright Information:
© 2011 Blackwell Publishing Ltd.
Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
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MeSH Terms
Ewa Lundgren / ; Göran Akerström / ; Sverker Ljunghall / ; Jörgen Nordenström / ; Ove Tørring / ; Lars Ove Farnebo / ; Leif Mosekilde / ; Jan Falch / ; Per Pfeffer / ; Jan-Erik Varhaug / ; Sylvi Aanderud / ; Marek Baranowski /

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