Evaluation of the risk of developing atrial fibrillation with new electrocardiographic parameters in patients with primary hyperparathyroidism
Öz
Aims: Primary hyperparathyroidism (PHPT) is a clinical entity characterized by hypercalcemia caused by excessive parathyroid hormone (PTH) secretion from the parathyroid gland and is the most common cause of hypercalcemia in outpatient clinics. Atrial fibrillation (AF) is a common arrhythmia encountered in cardiology practice, the prevalence of which increases with concomitant heart disease and age. P-wave peak time (PWPT) is the time from the onset of the p-wave to its peak and is a recently defined electrocardiographic (ECG) parameter. Recently, studies on the relationship between PWPT and cardiovascular events have been published. In this study, we aimed to evaluate the risk of AF in PHPT patients by detecting PWPT, a new ECG parameter.
Methods: The study included 21 PHPT patients and 20 healthy subjects as a control group. The groups were compared in terms of demographic characteristics, laboratory findings, echocardiography, and ECG findings. D2 and V1 leads were used for PWPT, as recommended in the literature.
Results: When the patient group was compared with the control group, no difference was detected in terms of demographic characteristics and laboratory findings. When compared with the control group, patients with PHPT had significantly longer PWPT (PWPTV1 56.07 msec ± 8.33 s vs. 50.25 msec ± 7.00 s p<0.05, PWPTD2 54.57 msec ± 6.28 msec vs. 48.05 msec ± 5.91 msec p<0.01).
Conclusion: We observed that PWPT was longer in patients with PHPT compared to controls, and our results suggest that PHPT patients are at risk of AF.
Anahtar Kelimeler
Primary hyperparathyroidism hypercalcemia atrial fibrillation P-wave peak time
Kaynakça
- Boonen S, Bouillon R, Fagard K, Mullens A, Vlayen J, Vanderschueren D. Primary hyperparathyroidism: pathophysiology, diagnosis and indications for surgery. Acta Otorhinolaryngol Belg. 2001;55(2):119-127.
- Lundgren E, Rastad J, Thrufjell E, Akerström G, Ljunghall S. Population-based screening for primary hyperparathyroidism with serum calcium and parathyroid hormone values in menopausal women. Surgery. 1997;121(3):287-294.
- Luigi P, Chiara FM, Laura Z, et al. Arterial hypertension, metabolic syndrome and subclinical cardiovascular organ damage in patients with asymptomatic primary hyperparathyroidism before and after parathyroidectomy: preliminary results. Int J Endocrinol. 2012;2012:408295.
- Silverberg SJ, Bilezikian JP. Hyperparathyroidism. In: Becker KL, editor. Principles and practice of endocrinology and metabolism. 3rd edition. Philadelphia: JB Lipincott; 2001. p. 564-73.
- Hedbäck G, Odén A, Tisell LE. The influence of surgery on the risk of death in patients with primary hyperparathyroidism. World J Surg. 1991;15(3):399-407.
- Piovesan A, Molineri N, Casasso F, et al. Left ventricular hypertrophy in primary hyperparathyroidism. effects of successful parathyroidectomy. Clin Endocrinol (Oxf). 1999;50(3):321-328.
- January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. Circulation. 2014;130(23):2071-2104.
- Miller JD, Aronis KN, Chrispin J, et al. Obesity, exercise, obstructive sleep apnea, and modifiable atherosclerotic cardiovascular disease risk factors in atrial fibrillation. J Am Coll Cardiol. 2015;66(25):2899-2906.
- Yıldız İ, Özmen Yildiz P, Burak C, et al. P wave peak time for predicting an increased left atrial volume index in hemodialysis patients. Med Princ Pract. 2020;29(3):262-269.
- Çağdaş M, Karakoyun S, Rencüzoğulları İ, et al. P wave peak time; a novel electrocardiographic parameter in the assessment of coronary no-reflow. J Electrocardiol. 2017;50(5):584-590.
- Burak C, Çağdaş M, Rencüzoğulları I, et al. Association of P wave peak time with left ventricular end-diastolic pressure in patients with hypertension. J Clin Hypertens (Greenwich). 2019;21(5):608-615.
- Yıldırım E, Günay N, Bayam E, Keskin M, Ozturkeri B, Selcuk M. Relationship between paroxysmal atrial fibrillation and a novel electrocardiographic parameter P wave peak time. J Electrocardiol. 2019;57:81-86.
- Öz A, Cinar T, Kızılto Güler C, et al. Novel electrocardiography parameter for paroxysmal atrial fibrillation in acute ischaemic stroke patients: P wave peak time. Postgrad Med J. 2020;96(1140):584-588.
- Aslan B, Akyüz A, Işık F, et al. The effect of empagliflozin on P wave peak time and other P wave parameters in patients with diabetes mellitus. Pacing Clin Electrophysiol. 2022;45(3):323-329.
- Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1-39.e14.
- Lind L, Ljunghall S. Serum calcium and the ECG in patients with primary hyperparathyroidism. J Electrocardiol. 1994;27(2):99-103.
- Surawicz B. Role of electrolytes in etiology and management of cardiac arrhythmias. Prog Cardiovasc Dis. 1966;8(4):364-386.
- Rosenqvist M, Nordenström J, Andersson M, Edhag OK. Cardiac conduction in patients with hypercalcaemia due to primary hyperparathyroidism. Clin Endocrinol (Oxf). 1992;37(1):29-33.
- Kepez A, Yasar M, Sunbul M, et al. Evaluation of left ventricular functions in patients with primary hyperparathyroidism: is there any effect of parathyroidectomy?. Wien Klin Wochenschr. 2017;129(9-10):329-336.
- Komatsu T, Kunugita F, Ozawa M, et al. Relationship between impairment of the vascular endothelial function and the CHA2DS2-VASc score in patients with sinus rhythm and non-valvular atrial fibrillation. Intern Med. 2018;57(15):2131-2139.
- Ozdemir D, Kalkan GY, Bayram NA, et al. Evaluation of left ventricle functions by tissue Doppler, strain, and strain rate echocardiography in patients with primary hyperparathyroidism. Endocrine. 2014;47(2):609-617.
- Ekmekci A, Abaci N, Colak Ozbey N, et al. Endothelial function and endothelial nitric oxide synthase intron 4a/b polymorphism in primary hyperparathyroidism. J Endocrinol Invest. 2009;32(7): 611-616.
- Rosenqvist M, Nordenström J, Andersson M, Edhag OK. Cardiac conduction in patients with hypercalcaemia due to primary hyperparathyroidism. Clin Endocrinol (Oxf). 1992;37(1):29-33.
- Curione M, Letizia C, Amato S, et al. Increased risk of cardiac death in primary hyperparathyroidism: what is a role of electrical instability? Int J Cardiol. 2007;121(2):200-202.
- Chang HC, Cheng HM. P wave peak time: A time window to evaluate left ventricular diastolic function. J Clin Hypertens (Greenwich). 2019;21(5):616-617.
- Keleşoğlu Ş, Yilmaz Y, Gökay F, Simsek Y, Calapkorur B, Elcik D. Atrial electromechanical delay is impaired in patients with primary hyperparathyroidism. Endokrynol Pol. 2021;72(5):550-557.
- Rienstra M, Lubitz SA, Zhang ML, Cooper RR, Ellinor PT. Elevation of parathyroid hormone levels in atrial fibrillation. J Am Coll Cardiol. 2011;57(25):2542-2543.
- Lee KH, Shin MH, Park HW, Cho JG, Kweon SS, Lee YH. Association between serum parathyroid hormone levels and the prevalence of atrial fibrillation: the Dong-gu study. Korean Circ J. 2018;48(2):159-167.
- Pepe J, Cipriani C, Curione M, et al. Reduction of arrhythmias in primary hyperparathyroidism, by parathyroidectomy, evaluated with 24-h ECG monitoring. Eur J Endocrinol. 2018;179(2):117-124.
Öz
Kaynakça
- Boonen S, Bouillon R, Fagard K, Mullens A, Vlayen J, Vanderschueren D. Primary hyperparathyroidism: pathophysiology, diagnosis and indications for surgery. Acta Otorhinolaryngol Belg. 2001;55(2):119-127.
- Lundgren E, Rastad J, Thrufjell E, Akerström G, Ljunghall S. Population-based screening for primary hyperparathyroidism with serum calcium and parathyroid hormone values in menopausal women. Surgery. 1997;121(3):287-294.
- Luigi P, Chiara FM, Laura Z, et al. Arterial hypertension, metabolic syndrome and subclinical cardiovascular organ damage in patients with asymptomatic primary hyperparathyroidism before and after parathyroidectomy: preliminary results. Int J Endocrinol. 2012;2012:408295.
- Silverberg SJ, Bilezikian JP. Hyperparathyroidism. In: Becker KL, editor. Principles and practice of endocrinology and metabolism. 3rd edition. Philadelphia: JB Lipincott; 2001. p. 564-73.
- Hedbäck G, Odén A, Tisell LE. The influence of surgery on the risk of death in patients with primary hyperparathyroidism. World J Surg. 1991;15(3):399-407.
- Piovesan A, Molineri N, Casasso F, et al. Left ventricular hypertrophy in primary hyperparathyroidism. effects of successful parathyroidectomy. Clin Endocrinol (Oxf). 1999;50(3):321-328.
- January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. Circulation. 2014;130(23):2071-2104.
- Miller JD, Aronis KN, Chrispin J, et al. Obesity, exercise, obstructive sleep apnea, and modifiable atherosclerotic cardiovascular disease risk factors in atrial fibrillation. J Am Coll Cardiol. 2015;66(25):2899-2906.
- Yıldız İ, Özmen Yildiz P, Burak C, et al. P wave peak time for predicting an increased left atrial volume index in hemodialysis patients. Med Princ Pract. 2020;29(3):262-269.
- Çağdaş M, Karakoyun S, Rencüzoğulları İ, et al. P wave peak time; a novel electrocardiographic parameter in the assessment of coronary no-reflow. J Electrocardiol. 2017;50(5):584-590.
- Burak C, Çağdaş M, Rencüzoğulları I, et al. Association of P wave peak time with left ventricular end-diastolic pressure in patients with hypertension. J Clin Hypertens (Greenwich). 2019;21(5):608-615.
- Yıldırım E, Günay N, Bayam E, Keskin M, Ozturkeri B, Selcuk M. Relationship between paroxysmal atrial fibrillation and a novel electrocardiographic parameter P wave peak time. J Electrocardiol. 2019;57:81-86.
- Öz A, Cinar T, Kızılto Güler C, et al. Novel electrocardiography parameter for paroxysmal atrial fibrillation in acute ischaemic stroke patients: P wave peak time. Postgrad Med J. 2020;96(1140):584-588.
- Aslan B, Akyüz A, Işık F, et al. The effect of empagliflozin on P wave peak time and other P wave parameters in patients with diabetes mellitus. Pacing Clin Electrophysiol. 2022;45(3):323-329.
- Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1-39.e14.
- Lind L, Ljunghall S. Serum calcium and the ECG in patients with primary hyperparathyroidism. J Electrocardiol. 1994;27(2):99-103.
- Surawicz B. Role of electrolytes in etiology and management of cardiac arrhythmias. Prog Cardiovasc Dis. 1966;8(4):364-386.
- Rosenqvist M, Nordenström J, Andersson M, Edhag OK. Cardiac conduction in patients with hypercalcaemia due to primary hyperparathyroidism. Clin Endocrinol (Oxf). 1992;37(1):29-33.
- Kepez A, Yasar M, Sunbul M, et al. Evaluation of left ventricular functions in patients with primary hyperparathyroidism: is there any effect of parathyroidectomy?. Wien Klin Wochenschr. 2017;129(9-10):329-336.
- Komatsu T, Kunugita F, Ozawa M, et al. Relationship between impairment of the vascular endothelial function and the CHA2DS2-VASc score in patients with sinus rhythm and non-valvular atrial fibrillation. Intern Med. 2018;57(15):2131-2139.
- Ozdemir D, Kalkan GY, Bayram NA, et al. Evaluation of left ventricle functions by tissue Doppler, strain, and strain rate echocardiography in patients with primary hyperparathyroidism. Endocrine. 2014;47(2):609-617.
- Ekmekci A, Abaci N, Colak Ozbey N, et al. Endothelial function and endothelial nitric oxide synthase intron 4a/b polymorphism in primary hyperparathyroidism. J Endocrinol Invest. 2009;32(7): 611-616.
- Rosenqvist M, Nordenström J, Andersson M, Edhag OK. Cardiac conduction in patients with hypercalcaemia due to primary hyperparathyroidism. Clin Endocrinol (Oxf). 1992;37(1):29-33.
- Curione M, Letizia C, Amato S, et al. Increased risk of cardiac death in primary hyperparathyroidism: what is a role of electrical instability? Int J Cardiol. 2007;121(2):200-202.
- Chang HC, Cheng HM. P wave peak time: A time window to evaluate left ventricular diastolic function. J Clin Hypertens (Greenwich). 2019;21(5):616-617.
- Keleşoğlu Ş, Yilmaz Y, Gökay F, Simsek Y, Calapkorur B, Elcik D. Atrial electromechanical delay is impaired in patients with primary hyperparathyroidism. Endokrynol Pol. 2021;72(5):550-557.
- Rienstra M, Lubitz SA, Zhang ML, Cooper RR, Ellinor PT. Elevation of parathyroid hormone levels in atrial fibrillation. J Am Coll Cardiol. 2011;57(25):2542-2543.
- Lee KH, Shin MH, Park HW, Cho JG, Kweon SS, Lee YH. Association between serum parathyroid hormone levels and the prevalence of atrial fibrillation: the Dong-gu study. Korean Circ J. 2018;48(2):159-167.
- Pepe J, Cipriani C, Curione M, et al. Reduction of arrhythmias in primary hyperparathyroidism, by parathyroidectomy, evaluated with 24-h ECG monitoring. Eur J Endocrinol. 2018;179(2):117-124.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Kardiyoloji |
| Bölüm | Research Articles |
| Yazarlar | |
| Erken Görünüm Tarihi | 26 Ekim 2023 |
| Yayımlanma Tarihi | 27 Ekim 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 5 Sayı: 4 |
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