Relation between parathyroid hormone and cardiac function in long-term hemodialysis patients.

Radionuclide ventriculographic and echocardiographic assessments of left ventricular cardiac function were studied in 46 long-term maintenance hemodialysis patients, and comparison of cardiac function pre- and post-parathyroidectomy in 10 hemodialysis patients with secondary hyperparathyroidism was investigated. In long-term hemodialysis patients, impairment of cardiac function was observed in 80.4%. In an overall study of 46 patients, no correlation between intact parathyroid hormone (iPTH) level and left ventricular ejection fraction (LVEF) was observed, but a significant (p < 0.05) negative correlation was observed in patients with an iPTh blood level over 200 pg/ml. A negative correlation between fractional fiber shortening and an iPTh level over 200 pg/ml was observed (p < 0.05). There was neither a correlation between the iPTH level and left ventricular (LV) mass, nor was there a correlation between the iPTH level and wall thickness. After parathyroidectomy, systolic and diastolic blood pressure, cardiothoracic ratio, LVEF, and LV mass decreased significantly (p < 0.05), but no significant difference was detected in cardiac thickness. In summary, the present data suggest that high levels over 200 pg/ml of the iPTH in long-term hemodialysis patients adversely affect the myocardial function, induce cardiac hypertrophy and cause high arterial blood pressure. After parathyroidectomy, the cardiac function improved with a reduction of cardiac mass and an improvement of cardiac contraction.