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PARATHYROIDECTOMY ELIMINATES ARRHYTHMIC RISK IN PRIMARY HYPERPARATHYROIDISM, AS EVALUATED BY EXERCISE TEST.
MedLine Citation:
PMID:  23744591     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: to investigate if parathyroidectomy reverses risk factors for arrhythmias, related to the QT dynamic changes evaluated during bicycle ergometry exercise test (ET). METHODS: twenty four postmenopausal women with primary hyperparathyroidism (PHPT) (mean age 60.0±8.4 years) and thirty, sex and age-matched, controls underwent ET, echocardiographic and biochemical evaluation. The following stages were considered during ET: rest, peak exercise, recovery. The patients were randomized to two groups: 12 underwent parathyroidectomy (Group A) and 12 were followed-up conservatively (Group B). After 6 months the patients were studied again. RESULTS: Group A and B, showed no differences in mean baseline biochemical values, echocardiographic parameters and QTc interval. PHPT patients, showed an increased occurrence of ventricular premature beats (VPBs) during ET compared with controls (37.0% vs 6.6%, p=0.03). Serum calcium level was a predictor of VPBs (p=0.05). Mean value of QTc was in the normal range at baseline (Group A: 401±16.9; Group B: 402.25±13.5 msec), but significantly shorter than controls (417.8±25.1 msec, p<0.01). A negative correlation was found between QTc and calcium values (p=0.03). Physiological reduction of QTc interval from rest to peak exercise was not observed in PHPT patients before surgery. After parathyroidectomy, Group A had a significant reduction in VPBs compared to baseline (at baseline, 5 out of 12 vs none out of 12 patients after parathyroidectomy, p=0.03) and a restored normal QT adaptation during ET. Group B showed no significant changes after a six month period. CONCLUSIONS: Parathyroidectomy reduces the occurrence of VPBs and restored the QTc adaptation during ET.
Authors:
Jessica Pepe; Mario Curione; Sergio Morelli; Marisa Varrenti; Camillo Cammarota; Mirella Cilli; Sara Piemonte; Cristiana Cipriani; Claudio Savoriti; Orlando Raimo; Federica De Lucia; Luciano Colangelo; Carolina Clementelli; Elisabetta Romagnoli; Salvatore Minisola
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-6-6
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  -     ISSN:  1479-683X     ISO Abbreviation:  Eur. J. Endocrinol.     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-6-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
J Pepe, internal medicine and medical disciplines, "Sapienza", University of Rome, Rome, Italy.
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