Long-term Effects of Parathyroidectomy on Cardiac and Autonomic Nervous System Functions in Haemodialysis Patients

Abstract

Ten patients receiving regular haemodialysis therapy who underwent parathyroidectomy for secondary hyperparathyroidism were investigated to evaluate the effects of parathyroid hormone on left ventricular and autonomic nervous system functions. The study which included M-mode echocardiography and autonomic nervous system tests (hormonal and cardiovascular response to the postural test, cold pressor test, handgrip test, diving reflex test and Valsalva manoeuvre) were performed prior to parathyroidectomy, and 5-8 months after, on a nondialysis day. The cardiovascular response and plasma noradrenaline changes to postural test remained unchanged following parathyroidectomy. The resting heart rate decreased from 73.1 +/- 2.4 to 66.4 +/- 2.3 beats/min (P less than 0.05) but mean blood pressure did not change post-parathyroidectomy. Mean blood pressure and heart rate changes during the cold pressor test, handgrip test, diving test and Valsalva manoeuvre were unaffected by parathyroidectomy. End-diastolic and end-systolic dimensions, fractional fibre shortening, mean velocity of fibre shortening and the ratio of the pre-ejection period to the left ventricular ejection time were normal prior to parathyroidectomy and remained unchanged following it. This study suggests that the reduction in parathyroid hormone concentrations obtained by parathyroidectomy does not significantly modify heart function and autonomic nervous system activity in the long term.