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Postexercise Cardiac Performance Among Patients With Mild Primary Hyperparathyroidism

Birgander, Mats MD*; Bondeson, Anne-Greth MD, PhD†; Bondeson, Lennart MD, PhD‡; Willenheimer, Ronnie MD, PhD*; Rydberg, Erik MD, PhD*

doi: 10.1097/TEN.0b013e3181c0478b
Preliminary Study

Primary hyperparathyroidism (pHPT) is associated with cardiac disease. This prospective study was designed to investigate changes in cardiac function before and after parathyroidectomy. Resting and post exercise cardiac function was compared with matched control subjects.

Fifty patients (mean age 62.9 ± 11 years, 45 women) and 50 healthy control subjects, matched for age and sex were studied. Resting and postmaximum exercise echocardiography/Doppler examination were performed at baseline and 6 months after parathyroidectomy. pHPT patients were tested at baseline and 6 months postoperatively. Control subjects were tested only at baseline. Patients were divided into 4 subgroups based on median preoperative levels of PTH and calcium (Ca): high (↑) PTH/↑ Ca, ↑ PTH/low (↓) Ca, ↑ Ca/↓ PTH, and ↓ PTH/↓ Ca.

No significant difference between pHPT patients and control subjects regarding post exercise systolic function were detected. There was a tendency of lowed E/A among pHPT patients which was significant in subgroup ↓PTH/↓Ca (1.07 ± 0.3). Subgroup ↑PTH/↑Ca showed a lower S/D compared with control subjects at baseline (1.28 ± 0.3 vs. 1.48 ± 0.3, P = 0.029). No significant changes regarding post exercise echocardiographic parameters reflecting cardiac function were detected 6 months after parathyriodectomy.

Patients with asymptomatic pHPT showed a tendency of elevated filling pressures and signs of impaired diastolic function during exercise.

From the Departments of *Cardiology, †Surgery, and ‡Pathology, Malmö University Hospital, Lund University, Sweden.

Supported by the Swedish Heart and Lung foundation and the Association of the foundation of Anna-Lisa and Sven-Eric Lundgren.

Reprints: Mats Birgander, MD, Department of Cardiology, Malmö University Hospital, S-205 02 Malmö, Sweden. E-mail:

© 2009 Lippincott Williams & Wilkins, Inc.