Abstract 17112: Impact of Hyperparathyroidism on Left Ventricular Structure: A Meta Analysis of 367 Patients
Background. Primary hyperparathyroidism (PHPT) is associated with an increased risk of cardiovascular mortality. To date, studies comparing left ventricular (LV) structure in patients (pts) with untreated PHPT to controls have reported mixed results. To this end, we performed a meta-analysis of studies comparing LV structure in untreated PHPT pts versus controls using echocardiographic techniques.
Methods. The published literature was scanned using searches of electronic databases (PubMed, MEDLINE) and references of relevant articles. The primary echocardiographic metrics included LV mass index (LVMI), LV posterior wall thickness (PWT), and interventricular septal thickness (IVST). PHPT pts were compared to controls with respect to pooled estimates of difference in means and 95% confidence intervals (95%CI) using a weighted random effects model.
Results. We identified 12 studies that including 367 PHPT pts and 404 controls (76% female, 74 years, parathyroid hormone 4.0 times normal). In these studies, LVMI was greater in PHPT pts versus controls (9 studies; p=0.045; difference in means 9.4 gram/m2, 95%CI 0.2-18.6). This difference was related to increases in both IVST (p=0.002; difference in means 0.47mm, 95%CI 0.17-0.77) and PWT (p=0.047; difference in means 0.47mm, 95%CI 0.01-0.94). No differences in systolic or diastolic LV volumes were noted, or in fractional shortening (all p=NS). Diastolic function, as measured by E/A and interventricular relaxation time was also unchanged (all p=NS).
Conclusions. Compared to controls, pts with untreated PHPT have greater LV mass index and LV wall thickness without alteration in LV volumes or function. These findings may contribute to the increased cardiovascular risk found in these pts.
- © 2011 by American Heart Association, Inc.