Stefenelli T, Mayr H, Bergler-Klein J, Globits S, Woloszczuk W, Niederle B
Department of Medicine II (Cardiology), University of Vienna, Austria.
Am J Med. 1993 Aug;95(2):197-202. doi: 10.1016/0002-9343(93)90260-v.
This prospective study was designed to assess the effect of primary hyperparathyroidism on heart muscle, valves, and myocardial function. Echocardiography was used to evaluate changes in mechanical performance, the thickness of the left ventricular wall, myocardial calcific deposits, and valvular calcifications in patients with primary hyperparathyroidism.
Echocardiography was performed in 54 patients with hyperparathyroidism prior to surgery and 12 +/- 2 months after successful parathyroidectomy. A matched control group was followed for comparison.
In a blinded fashion, aortic and mitral valve calcifications were detected in 63% and 49% of patients with primary hyperparathyroidism (controls: 12% and 15%, respectively). Calcific deposits in the myocardium were found in 69% of patients with hyperparathyroidism and 17% of the control subjects. After parathyroidectomy and 12 months of normocalcemia, a significant regression of left ventricular hypertrophy (p < 0.001) was observed.
The present data show a high incidence of left ventricular hypertrophy, calcific deposits in the myocardium, and/or aortic and mitral valve calcification in patients with primary hyperparathyroidism. A 1-year follow-up after parathyroidectomy (and restoration of normocalcemia) discloses regression of hypertrophy, while calcifications persist without evidence of progression.
本前瞻性研究旨在评估原发性甲状旁腺功能亢进对心肌、瓣膜及心肌功能的影响。采用超声心动图评估原发性甲状旁腺功能亢进患者的机械性能变化、左心室壁厚度、心肌钙化沉积及瓣膜钙化情况。
对54例甲状旁腺功能亢进患者在手术前及成功进行甲状旁腺切除术后12±2个月进行超声心动图检查。设立匹配的对照组进行对比。
在盲法检测中，原发性甲状旁腺功能亢进患者中主动脉瓣和二尖瓣钙化的检出率分别为63%和49%（对照组分别为12%和15%）。甲状旁腺功能亢进患者中心肌钙化沉积的检出率为69%，对照组为17%。甲状旁腺切除术后且血钙正常12个月后，观察到左心室肥厚显著消退（p<0.001）。
目前的数据显示，原发性甲状旁腺功能亢进患者左心室肥厚、心肌钙化沉积和/或主动脉瓣及二尖瓣钙化的发生率较高。甲状旁腺切除术后（并恢复血钙正常）1年的随访显示肥厚消退，而钙化持续存在且无进展迹象。
