Changes in cardiac functions in patients treated with parathyroidectomy for secondary hyperparathyroidism.

Abstract

Our study aims to investigate the changes in cardiac functions, especially myocardial performance index (MPI), in patients who underwent parathyroidectomy for secondary hyperparathyroidism. Patients who underwent parathyroidectomy for secondary hyperparathyroidism between June 2010 and September 2021 were analyzed retrospectively. The patients were divided into two groups: those who underwent total parathyroidectomy (group 1) and those who underwent subtotal parathyroidectomy (group 2). The groups were compared according to the echocardiogram findings performed in the preoperative period and the postoperative sixth month. In addition, cardiac structure, and systolic and diastolic functions, especially myocardial performance index, were evaluated by echocardiography and Doppler imaging. Thirty-seven patients were examined; 16 (43.2%) underwent total parathyroidectomy, and 21 (56.8%) had subtotal parathyroidectomy performed. Group 1's mean left ventricular end-systolic diameter (LVES) decreased from 2.53 ± 0.57 to 2.35 ± 0.37cm after parathyroidectomy. In Group 1, the postoperative value of LVES and end-systolic volume decreased significantly compared to the preoperative period (p = 0.042, p = 0.008, respectively). EF increased from 59.25 ± 0.05 to 67.81 ± 4.04. In Group 1, EF and EV postoperatively increased significantly compared to the preoperative period (p = 0.023, p = 0.021, respectively). The mean MPI decreased from 0.45 ± 0.07 to 0.39 ± 0.04 after parathyroidectomy in group 1. In group 2, it decreased from 0.46 ± 0.06 to 0.40 ± 0.04 (p < 0.001). The present study provides an improvement in myocardial functions after parathyroidectomy. While LVES, EF, ejection volume, end-systolic volume, and MPI improved in both groups, the MPI improvement was more evident in the total parathyroidectomy group.