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Parathyroidectomy may reduce left ventricular mass in primary hyperparathyroidism
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Left ventricular mass in primary hyperparathyroidism was reduced with parathyroidectomy, and higher preoperative parathyroid hormone levels yielded greater improvements, according to recent study findings published in The Journal of Clinical Endocrinology & Metabolism.
“Our results indicate that [parathyroidectomy] is associated with an 11.6 g/m2 decline in [left ventricular mass index] in [primary hyperparathyroidism],” the researchers wrote. “Greater disease severity, reflected by higher preoperative serum [parathyroid hormone], was associated with a greater decrease in [left ventricular mass], while higher calcium level was not. This observation lends credence to the hypothesis that [parathyroid hormone], rather than calcium, may be the causal factor leading to [left ventricular hypertrophy] in [primary hyperparathyroidism].”
Marcella Donovan Walker, MD, of Columbia University, and colleagues conducted a meta-analysis of 15 studies with 457 participants with primary hyperparathyroidism who underwent parathyroidectomy to determine whether the surgery benefits left ventricular mass.
On average, there was an 11.6 g/m2 decrease in left ventricular mass after parathyroidectomy.
Left ventricular mass was reduced in studies with shorter duration ( 6 months), but longer studies (1 or 2 years) showed no benefit.
Compared with randomized controlled trials, observational studies revealed significant declines in left ventricular mass and higher serum calcium and parathyroid hormone (PTH) levels. The surgical effect on reducing left ventricular mass was greater for every 10 pg/mL increase in preoperative PTH level, whereas preoperative calcium had no effect.
“Because disease severity was not independent of study design, further work is needed to understand which factors are most important in influencing the change in [left ventricular mass] after [parathyroidectomy] in [primary hyperparathyroidism] and whether the benefit persists beyond 6-months post-[parathyroidectomy],” the researchers wrote. – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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