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Can parathyroid hormone be used as a biomarker for heart failure?

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Abstract

Secondary hyperparathyroidism in heart failure is a consequence of renin–angiotensin–aldosterone activation, chronic hyperaldosteronism, and loop diuretic usage, resulting in calcium excretion. The result is an inflammatory state with adverse effects on myocardial remodeling and systemic complications. Recent literature has suggested that elevated parathyroid hormone predicts adverse outcomes in patients with heart failure independent of serum calcium and phosphate, vitamin D deficiency, and renal insufficiency. Parathyroid hormone has been correlated with elevated brain natriuretic peptide levels, an established biomarker of heart failure severity. There are several limitations to the utilization of parathyroid hormone as a biomarker for heart failure, and further prospective studies need to be conducted to assess the value of multiple parathyroid hormone measurements over time and elucidate the role of parathyroid hormone in diastolic dysfunction. Pending further validation, there is promise for parathyroid hormone as a complementary biomarker in heart failure.

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Conflict of interest

The authors do not believe that they have any conflicts of interest with regard to this research paper.

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Authors and Affiliations

  1. Department of Medicine, University of Toronto, Toronto, ON, Canada

    Sumeet Gandhi

  2. Division of Cardiology, Sunnybrook Health Sciences Centre, A-217, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada

    Robert B. H. Myers

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  1. Sumeet Gandhi
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  2. Robert B. H. Myers
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Correspondence to Robert B. H. Myers.

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Gandhi, S., Myers, R.B.H. Can parathyroid hormone be used as a biomarker for heart failure?. Heart Fail Rev 18, 465–473 (2013). https://doi.org/10.1007/s10741-012-9336-9

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  • DOI: https://doi.org/10.1007/s10741-012-9336-9

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