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Impairment of flow mediated vasodilatation of brachial artery in patients with primary hyperparathyroidism

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Abstract

Background

Hyperparathyroid condition might influence endothelial cells. The aim of this study was to assess flow mediated dilatation (FMD) in patients with primary hyperparathyroidism (PHPT).

Methods

We prospectively evaluated 21 patients with PHPT (9 women, 12 men; aged 50 ± 11 years, serum calcium 11.6 ± 0.7 mg/dl, intact parathyroid hormone (iPTH) 489 ± 495 pg/ml) and 27 healthy control subjects (13 women, 14 men; aged 49 ± 10 years, serum calcium 9.4 ± 0.5 mg/dl, iPTH 28 ± 8.5 pg/ml). Endothelial function, measured as FMD of the brachial artery using ultrasound, was calculated in two groups. To avoid confounding factors, conditions known to affect endothelial function like diabetes mellitus, hypertension, dyslipidemia, smoking, coronary and peripheral artery disease were excluded from both groups.

Results

FMD was lower in patients with PHPT than that in those without (10.2 ± 5.8 vs. 19.8 ± 5.8, P = 0.0001). FMD negatively correlated with serum calcium (r = −0.55, P = 0.002).

Conclusion

Endothelium-dependent FMD may impair in patients with PHPT compared to controls. Endothelial dysfunction can contribute to the deleterious cardiovascular effects of PTH excess. Therapy to reduce or retard endothelial dysfunction in patients with PHPT may lead to decreased cardiovascular morbidity and mortality.

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References

  1. Palmer M, Adami HO, Bergström R, Akerstöm G, Ljunghall S (1987) Mortality after surgery for primary hyperparathyroidism: a follow-up of 441 patients operated on from 1956 to 1979. Surgery 102:1–7

    PubMed  CAS  Google Scholar 

  2. Hedback G, Tisell LE, Bengtsson BA, Hedman I, Oden A (1990) Premature death in patients operated on for primary hyperparathyroidism. World J Surg 14:829–836

    Article  PubMed  CAS  Google Scholar 

  3. Sivula A, Ronni-Sivula H (1987) Natural history of treated primary hyperparathyroidism. Surg Clin North Am 67:329–341

    PubMed  CAS  Google Scholar 

  4. Palmer M, Adami HO, Bergstrom R, Jakobsson S, Akestrom G, Ljunghall S (1987) Survival and renal function in untreated hypercalcemia. Population-based cohort study with 14 years of follow up. Lancet 10:59–62

    Google Scholar 

  5. Wermers RA, Khosla S, Atkinson EJ et al (1998) Survival after the diagnosis of hyperparathyroidism: a population-based study. Am J Med 2:115–122

    Article  Google Scholar 

  6. Dalberg K, Brodin LA, Juhlin-Dannfelt A, Farnebo LO (1996) Cardiac function in primary hyperparathyroidism before and after operation. Eur J Surg 162:171–176

    PubMed  CAS  Google Scholar 

  7. Piovesan A, Molineri N, Casasso F et al (1999) Left ventricular hypertrophy in primary hyperparathyroidism: effects of successful parathyroidectomy. Clin Endocrinol 50:321–328

    Article  CAS  Google Scholar 

  8. Söreide JA, van Heerden JA, Grant CS, Yau Lo C, Schleck C, Ilstrup DM (1997) Survival after surgical treatment for primary hyperparathyroidism. Surgery 122:1117–1123

    Article  PubMed  Google Scholar 

  9. Kumar S, Olukoga AO, Gordon C et al (1994) Impaired glucose tolerance and insulin insensitivity in primary hyperparathyroidism. Clin Endocrinol (Oxf) 40:47–53

    CAS  Google Scholar 

  10. Taylor W (1991) The prevalance of diabetes mellitus in patients with primary hyperparathyroidism and among their relatives. Diabet Med 8:683–687

    PubMed  CAS  Google Scholar 

  11. Lundgren E, Ljunghall S, Akerström G, Hetta J, Mallmin H, Rasted J (1998) Case–control study on symptoms and signs of “asymptomatic” primary hyperparathyroidism. Surgery 124:980–985

    PubMed  CAS  Google Scholar 

  12. Nainby-Luxmoore JC, Langford HG, Nelson NC, Watson RL, Barnes TY (1982) A case–comparison study of hypertension and hyperparathyroidism. J Clin Endocrinol Metab 55:303–306

    Article  PubMed  CAS  Google Scholar 

  13. Marx SJ (2000) Hyperparathyroid and hypoparathyroid disorders. N Engl J Med 343:1863–1875

    Article  PubMed  CAS  Google Scholar 

  14. Rubanyi GM (1993) The role of endothelium in cardiovascular homeostasis and diseases. J Cardiovasc Pharmacol 22(Suppl 4):S1–S14

    PubMed  CAS  Google Scholar 

  15. Celermajer DS, Sorensen KE, Gooch VM et al (1992) Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 340:1111–1115

    Article  PubMed  CAS  Google Scholar 

  16. Neunteufl T, Heher S, Katzenschlager R et al (2000) Late prognostic value of flow-mediated dilatation in the brachial artery of patients with chest pain. Am J Cardiol 86:207–210

    Article  PubMed  CAS  Google Scholar 

  17. Lundgren E, Szabo E, Ljunghall S, Holmberg L, Rastad J (1998) Population based case–control study of sick leave in postmenopausal women before diagnosis of hyperparathyroidism. Br Med J 317:848–851

    CAS  Google Scholar 

  18. Rastad J, Akerstrom G, Ljunghall S (1995) Mortality of untreated primary hyperparathyroidism-a nontraditional indication for parathyroid surgery? Am J Med 99:577–578

    Article  PubMed  CAS  Google Scholar 

  19. Symons C, Fortune F, Greenbaum RA, Dandona P (1985) Cardiac hypertrophy, cardiomyopathy, and hyperparathyroidism-an association. Br Heart J 54:539–542

    PubMed  CAS  Google Scholar 

  20. Corretti MC, Anderson TJ, Benjamin EJ et al (2002) Guidelines fort the ultrasound assessment of endothelial-dependent flow-mediated dilatation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force. J Am Coll Cardiol 39:257–265

    Article  PubMed  Google Scholar 

  21. Silverberg SJ (2000) Cardiovascular disease in primary hyperparathyroidism. J Clin Endocrinol Metab 85:3513–3514

    Article  PubMed  CAS  Google Scholar 

  22. Brickman A, Nyby M, von Hungen K, Eggena P, Tuck ML (1990) Calciotropic hormones, platelet calcium, and blood pressure in essential hypertension. Hypertension 16:515–522

    PubMed  CAS  Google Scholar 

  23. Duprez D, Bauwens F, De Buyzere M et al (1991) Relationship between parathyroid hormone and left ventricular mass in moderate essential hypertension. J Hypertension 9:S116–S117

    CAS  Google Scholar 

  24. Antony I, Lerebours G, Nitenber A (1995) Loss of flow-mediated coronary artery dilatation in patients with hypertension. Circulation 91:1624–1628

    PubMed  CAS  Google Scholar 

  25. Sorensen KE, Celermajer DS, Georgapoulos D, Hatcher G, Betteridge DJ, Deanfield JE (1994) Impairment of endothelium-dependent dilatation is an early event and is related to the lipoprotein (a) level. J Clin Invest 93:50–55

    PubMed  CAS  Google Scholar 

  26. Ross R (1993) The pathogenesis of atherosclerosis: a perspective fort he 1990s. Nature 362:801–809

    Article  PubMed  CAS  Google Scholar 

  27. Neunteufl T, Katzenschlager R, Hassan A et al (1997) Systemic endothelial dysfunction is related to the extent and severity of coronary artery disease. Atherosclerosis 129:111–118

    Article  PubMed  CAS  Google Scholar 

  28. Anderson TJ, Uehata A, Gerhard MD et al (1995) Close relation of endothelial function in the human coronary and peripheral circulations. J Am Coll Cardiol 26:1235–1241

    Article  PubMed  CAS  Google Scholar 

  29. Celermajer DS, Sorensen KE, Gooch VM et al (1992) Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 340:1111–1115

    Article  PubMed  CAS  Google Scholar 

  30. Celermajer DS, Sorensen KE, Georgakopoulos D et al (1993) Cigarette smoking is associated with dose-related and potentially revesible impairment of endothelium-dependent dilatation in healthy young adults. Circulation 88:2149–2155

    PubMed  CAS  Google Scholar 

  31. Schlieffer R, Pernot F, Jones R (1995) Endothelium is a target organ of parathyroid secretions in genetic hypertensive rats. Horm Metab Res 27:16–18

    Google Scholar 

  32. Nickols GA (1987) Actions of parathyroid hormone in the cardiovascular system. Blood Vessels 24:120

    Article  PubMed  CAS  Google Scholar 

  33. Aman K, Flechtenmacher C, Tornig J et al (1996) Permissive effect of PTH on vascular wall hypertrophy of intramyocardial arteries in experimental renal failure. Med Clin 91:551–556

    Google Scholar 

  34. Hanson AS, Linas SL (1994) Parathyroid hormone/adenylate cyclase coupling in vascular smooth muscle cells. Hypertension 23:468–475

    PubMed  CAS  Google Scholar 

  35. Kosch M, Hausberg M, Vormbrock K et al (2000) Studies on flow-mediated vasodilatation and intima-media thickness of the brachial artery in patients with primary hyperparathyroidism. Am J Hypertens 13:759–764

    Article  PubMed  CAS  Google Scholar 

  36. Kosch M, Hausberg M, Vormbrock K et al (2000) Impaired flow-mediated vasodilatation of the brachial artery in patients with primary hyperparathyroidism improves after parathyroidectomy. Cardiovasc Res 47:813–818

    Article  PubMed  CAS  Google Scholar 

  37. Bogin E, Massry SG, Harary I (1981) Efeect of parathyroid hormone on rat heart cells. J Clin Invest 67:1215–1227

    Article  PubMed  CAS  Google Scholar 

  38. Barenbrock M, Hausberg M, Kosch M, Kisters K, Rahn KH (1998) Relation between calcium phosphate metabolism and flow-mediated vasodilatation of the brachial artery in patients after renal transplantation. Trace Elem Elec 15:168–172

    CAS  Google Scholar 

  39. Barenbrock M, Hausberg M, Kosch M, Kisters K, Hoeks APG, Rahn KH (1998) Effect of hyperparathyroidism on arterial distensibility in renal transplant patients. Kidney Int 54:210–215

    Article  PubMed  CAS  Google Scholar 

  40. Neunteufl T, Katzenschlager R, Abela C et al (1998) Impairement of endothelium-independent vasodilatation in patients with hypercalcemia. Cardiovasc Res 40:396–401

    Article  PubMed  CAS  Google Scholar 

  41. O’Driscoll G, Gren D, Taylor RR (1997) Simvastatin, an HMG-coenzyme A reductase inhibitor, improves endothelial function within 1 month. Circulation 95:1126–1131

    PubMed  CAS  Google Scholar 

  42. Woo KS, Chook P, Lolin YI, Sanderson JE, Celermajer DS (1999) Folic acid improves arterial endothelial function in adults with hyperhomocystinemia. J Am Coll Cardiol 34:202–204

    Article  Google Scholar 

  43. Corretti MC, Plotnick GD, Vogel RA (1998) Smoking correlates with flow-mediated brachial artery vasoactivity but not cold pressor activity in men with coronary artery disease. Int J Card Imaging 14:11–17

    Article  PubMed  CAS  Google Scholar 

  44. Anderson TJ, Elstein E, Haber H, Charbonneau F (2000) Comparative study of ACE inhibition, angiotensin II, antagonism, and calcium channel blockade on flow-mediated vasodilatation in patients with coronary disease. J Am Coll Cardiol 35:60–66

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiology, KTU Faculty of Medicine, 61080, Trabzon, Turkey

    Merih Baykan, Turan Erdoğan, Ömer Gedikli, Abdulkadir Kırış, Mehmet Küçükosmanoğlu & Şükrü Çelik

  2. Department of Internal Medicine, Division of Endocrinology and Metabolism, KTU Faculty of Medicine, Trabzon, Turkey

    Cihangir Erem, Arif Hacıhasanoğlu & Halil Önder Ersöz

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  1. Merih Baykan
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  2. Cihangir Erem
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  3. Turan Erdoğan
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Correspondence to Merih Baykan.

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Baykan, M., Erem, C., Erdoğan, T. et al. Impairment of flow mediated vasodilatation of brachial artery in patients with primary hyperparathyroidism. Int J Cardiovasc Imaging 23, 323–328 (2007). https://doi.org/10.1007/s10554-006-9166-8

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