Manifestations of left ventricular dysfunction and arrhythmia in patients with chronic hypoparathyroidism and pseudohypoparathyroidism: a preliminary study

• Published in: BMC endocrine disorders Vol. 20; no. 1; pp. 61 - 9
• Main Authors: Wang, Yabing, He, Kun, Wang, Ou, Lin, Xue, Chen, Sixing, Jiang, Yan, Li, Mei, Xia, Weibo, Xing, Xiaoping
• Format: Journal Article
• Language: English
• Published: London BioMed Central 11.05.2020; BioMed Central Ltd; BMC
• Subjects: Adolescent; Adult; Age; Arrhythmia; Arrhythmias, Cardiac - etiology; Arrhythmias, Cardiac - metabolism; Arrhythmias, Cardiac - physiopathology; Atrial Premature Complexes - etiology; Atrial Premature Complexes - metabolism; Atrial Premature Complexes - physiopathology; Basic and Clinical Endocrinology; Body mass index; Brain natriuretic peptide; Calcium; Calcium (blood); Calcium - metabolism; Cardiac arrhythmia; Cardiac patients; Cardiomyopathy; Cardiovascular disease; Care and treatment; Case-Control Studies; Cholesterol; Chronic Disease; Diabetes; Echocardiography; EKG; Electrocardiography; Electrocardiography, Ambulatory; Endocrinology; Enzymes; Female; Function; Heart; Humans; Hypertension; Hypocalcemia; Hypoparathyroidism; Hypoparathyroidism - complications; Hypoparathyroidism - metabolism; Hypoparathyroidism - physiopathology; Kidney diseases; Laboratories; Long QT Syndrome - etiology; Long QT Syndrome - metabolism; Long QT Syndrome - physiopathology; Male; Medical research; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Morphology; Natriuretic Peptide, Brain - metabolism; Natriuretic peptides; Parathyroid hormones; Patients; Phosphorus; Pilot Projects; Potassium; Pseudohypoparathyroidism; Pseudohypoparathyroidism - complications; Pseudohypoparathyroidism - metabolism; Pseudohypoparathyroidism - physiopathology; Research Article; rology; Structure-function relationships; Tachycardia; Tachycardia, Supraventricular - etiology; Tachycardia, Supraventricular - metabolism; Tachycardia, Supraventricular - physiopathology; Ventricle; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - etiology; Ventricular Dysfunction, Left - metabolism; Ventricular Dysfunction, Left - physiopathology; Ventricular Premature Complexes - etiology; Ventricular Premature Complexes - metabolism; Ventricular Premature Complexes - physiopathology; Vitamin D; Vitamin deficiency; Young Adult; Beijing China; United States > US; Heart; Function; Arrhythmia; Hypoparathyroidism; Pseudohypoparathyroidism
• ISSN: 1472-6823; 1472-6823
• DOI: 10.1186/s12902-020-0541-6

Background Cardiac damage triggered by severe hypocalcemia is well known. However, the role of chronic hypoparathyroidism (HP) and pseudohypoparathyroidism (PHP) in cardiac health is still unclear. We investigated the effect of chronic HP and PHP on cardiac structure and conductive function in patients compiling with treatment. Methods The study included 18 patients with HP and eight with PHP aged 45.4 ± 15.4 and 22.1 ± 6.4 years, respectively with a previously regular follow-up. In addition, 26 age- and sex-matched healthy controls were included. General characteristics and biochemical indices were recorded. Cardiac function and structure were assessed by estimation of myocardial enzymes, B-type natriuretic peptide (BNP), and echocardiography. The 12-lead electrocardiogram and 24-h Holter electrocardiography were performed to evaluate the conductive function. Results Levels of serum calcium in HP and PHP were 2.05 ± 0.16 mmol/L and 2.25 ± 0.19 mmol/L, respectively. The levels of myocardial enzyme and BNP were within the normal range. Adjusting for age at evaluation and body mass index, all M-mode measurements, left ventricular mass (LVM), LVM index (LVMI) and relative wall thickness (RWT) were comparable between patients and controls. Prolongation of corrected QT (QTc) intervals occurred in 52.6% (10/19) of patients, and 6.7% (1/15) of patients manifested more than 100 episodes of supraventricular and ventricular extrasystoles, as well as supraventricular tachycardia. None of the above arrhythmias was related to a severe clinical event. Conclusions From this pilot study, patients diagnosed with HP and PHP and well-controlled serum calcium levels manifested normal cardiac morphology and ventricular function, except for prolonged QTc intervals, and a small percentage of mild arrhythmias needing further investigation.