OBJECTIVE: To assess the impact of serum intact parathyroid hormone (PTH) levels on haemodynamic state and their relations by comparing plasma B-type natriuretic peptide (BNP) levels. DESIGN: Cross-sectional study in molecular epidemiology. SETTING: Mie University Hospital, Tsu, Japan. PATIENTS: Consecutive 105 patients with chronic heart failure (CHF). MAIN OUTCOME MEASURES: Serum intact PTH and plasma BNP levels were assessed simultaneously with right heart catheterisation. RESULTS: Although serum intact PTH levels (46±25 pg/ml) were within the normal range (<65 pg/ml) in 87% of patients, log-transformed intact PTH levels significantly correlated with pulmonary capillary wedge pressure (PCWP: 15±9 mm Hg, r=0.55, p<0.05) and heart rate (73±14/min, r=0.40, p<0.05), whereas log-transformed intact PTH levels were inversely correlated with stroke volume index (SVI: 38±11 ml/m(2), r=-0.52, p<0.05) and cardiac index (2.6±0.7 l/min/m(2), r=-0.41, p<0.05) in all patients. PCWP and SVI were independent determinants of log-transformed intact PTH levels (β=0.40 and -0.37, p<0.05, respectively) after adjusting for variables associated with PTH. Conversely, after adjusting for variables associated with CHF, log-transformed intact PTH levels were an independent determinant of PCWP, SVI, heart rate and cardiac index (β=0.38, -0.33, 0.32, and -0.25, p<0.05, respectively), and might be defined as a superior determinant of SVI and cardiac index compared with log-transformed BNP levels using stepwise multivariate regression analyses. CONCLUSIONS: Increased PCWP and decreased SVI independently contribute to elevated intact PTH in patients with CHF.
OBJECTIVE: To assess the impact of serum intact parathyroid hormone (PTH) levels on haemodynamic state and their relations by comparing plasma B-type natriuretic peptide (BNP) levels. DESIGN: Cross-sectional study in molecular epidemiology. SETTING: Mie University Hospital, Tsu, Japan. PATIENTS: Consecutive 105 patients with chronic heart failure (CHF). MAIN OUTCOME MEASURES: Serum intact PTH and plasma BNP levels were assessed simultaneously with right heart catheterisation. RESULTS: Although serum intact PTH levels (46±25 pg/ml) were within the normal range (<65 pg/ml) in 87% of patients, log-transformed intact PTH levels significantly correlated with pulmonary capillary wedge pressure (PCWP: 15±9 mm Hg, r=0.55, p<0.05) and heart rate (73±14/min, r=0.40, p<0.05), whereas log-transformed intact PTH levels were inversely correlated with stroke volume index (SVI: 38±11 ml/m(2), r=-0.52, p<0.05) and cardiac index (2.6±0.7 l/min/m(2), r=-0.41, p<0.05) in all patients. PCWP and SVI were independent determinants of log-transformed intact PTH levels (β=0.40 and -0.37, p<0.05, respectively) after adjusting for variables associated with PTH. Conversely, after adjusting for variables associated with CHF, log-transformed intact PTH levels were an independent determinant of PCWP, SVI, heart rate and cardiac index (β=0.38, -0.33, 0.32, and -0.25, p<0.05, respectively), and might be defined as a superior determinant of SVI and cardiac index compared with log-transformed BNP levels using stepwise multivariate regression analyses. CONCLUSIONS: Increased PCWP and decreased SVI independently contribute to elevated intact PTH in patients with CHF.
Authors: G Loncar; B Bozic; N Cvetinovic; H-D Dungen; M Lainscak; S von Haehling; W Doehner; Z Radojicic; B Putnikovic; T Trippel; V Popovic Journal: J Endocrinol Invest Date: 2016-10-13 Impact factor: 4.256