Abstract 16853: Prognostic Value of Plasma Parathyroid Hormone Levels in Adult Congenital Heart Disease
Introduction: Plasma parathyroid hormone (PTH) level predicts cardiovascular morbidity and mortality in patients with chronic heart failure. In the previous study, we showed that Vitamin D deficiency and secondary hyperparathyroidism are common in adult patients with congenital heart disease (CHD). However, the prognostic predictive value of plasma PTH level in adult patients with CHD remains unclear.
Hypothesis: We have hypothesized that plasma PTH level can predict cardiovascular morbidity and mortality in adult patients with CHD.
Method: This study was a single-center, prospective study, and consisted of 86 consecutive patients. An intact PTH laboratory test was ordered for each of the 86 patients. All of the patients underwent follow-up surveys for morbidity (hospitalization for heart failure) and mortality over 3 years. The enrolled patients were divided into two groups based on the levels (the upper limit of the normal range: 65 pg/ml) of PTH.
Results and Conclusions: According to the classification of the Working Group on research in adult congenital heart disease: National Heart, Lung, and Blood Institute, the 86 patients were classified as follows: 19 simple CHDs, 14 moderate severity CHDs, and 53 CHDs of great complexity. Intact-PTH values (median 60.5 pg/ml, interquartile range 45.8-82.3) were elevated in this cohort, and 41 (48 %) patients had intact-PTH values above the upper limit of the normal range. Between the two groups, the high-PTH group (PTH≧65 pg/ml) had significantly higher levels of brain natriuretic peptide (p = 0.011) and functional class (p = <0.001), and lower levels of estimated glomerular filtration ratio (p = 0.04), 25-hydroxyvitamin D (p < 0.001), cardiac index (p = 0.024) and 6-minute walking distance (p = 0.008). During a follow-up period (mean: 48 months), 8 patients died and 12 patients were hospitalized for heart failure. Kaplan-Meier survival curves demonstrate that patients with higher levels of intact PTH had higher mortality (Log-lank p = 0.029) and morbidity (Log-lank p = 0.034). Plasma PTH levels may have a prognostic value for mortality and morbidity in adult patients with CHD.
Author Disclosures: T. Shimizu: None. K. Inai: None. S. Asagai: None. E. Shimada: None. T. Shinohara: None. I.S. Park: None. T. Nakanishi: None.
- © 2016 by American Heart Association, Inc.