Endocrine Abstracts

Typical symptomatology of primary hyperparathyroidism (PNP) includes bone lesions and renal dysfunction in the form of recurrent nephrolithiasis but the symptoms of hypercalcemia may mimic other conditions, including cardiovascular diseases. The exact frequency of cardiac symptoms is not known. The study included 45 adult patients diagnosed with PNP, over 18 years of age, who were qualified for ptx. Laboratory tests included the determination of serum PTH, Ca, Pi and cardiac ECHO assessment of the heart, 24-hour recording of blood pressure using the Holter method and 24-hour Holter electrocardiography – the procedures were performed before the surgical treatment, and then as follow-up tests one month and six months after ptx; the follow-up ECHO assessment was performed 6 months after ptx. After ptx, the expected significant decrease in PTH concentration was achieved in all patients and the levels of Ca and Pi normalized (P < 0.001). The study group included 25 patients with hypertension (HT) (56%). Statistical significance was not achieved both in terms of BP change and the dipper/non-dipper parameters. The relationship between PTH and mean SBP and DBP was statistically significant. Patients were divided into two groups: patients with HT (25) and patients with normal BP (20) before ptx. After surgery, improvement in HT control was observed in 23 patients (92%); in this group it was found: BP normalization in 8 patients (35% in the improvement group), discontinuation or reduction of the amount of antihypertensive drugs in 13 patients (56% in the improvement group), achievement of the correct reduction of BP at night (non-dipper → dipper) in 14 patients (61% from the improvement group). In the analysis of ECG parameters before ptx and after surgery, a statistically significant change occurred in the QTc interval (P < 0.001). Among patients with SVBPs and VPBs before ptx, statistically significant improvement in SVBPs after ptx was observed. The QTc interval variable correlated with PTH and Ca before ptx. In ECHO, the IVS, LVEDD and LFEV did not differ statistically significantly between the tests before and after the procedure, whereas the parameters of RWT, LVM and LVMI differed statistically significantly – before the surgery they were significantly higher than after the surgery. The GLS value was significantly decreased in 27 (60%) patients after ptx. To conclude, the patients with PNP have a higher risk of cardiovascular diseases, observing the improvement of cardiological parameters after successful surgery.