Vitamin D, Parathyroid Hormone and Hypertrophic Myocardiopathy

• Type: Summary of Presentation in an International Conference
• Date: 2012

Authors

Sousa A (Author) Other; Lebreiro A (Author) Other; Martins E (Author) Other; Sousa C (Author) Other; Paiva M (Author) Other; Campelo M (Author) Other; Amorim S (Author) Other; Moura B (Author) Other; Silva Cardoso J (Author) Other; Maciel MJ (Author) FMUP

Conference proceedings International

Title: European Journal of Heart Failure Supplements

Initial page: P250

Heart Failure Congress 2012

Belgrade, 2012

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

Other information

Abstract (EN): Introduction: Vitamin D (25OHD) deficiency and increased parathyroid hormone (PTH) have been associated with multiple heart diseases and worse cardiovascular outcomes. Although hyperparathyroidism is a known cause of left ventricular (LV) hypertrophy, the exact role of PTH and 25OHD in hypertrophic myocardiopathy (HMC) is still unknown. We aimed to evaluate phospho-calcium metabolism (PCMet) in pts with HMC and their clinical significance. Methods: We measured different parameters of PCMet and analyzed demographic, clinical, laboratorial, echocardiographic and magnetic resonance (MR) data of pts with HMC, followed at a Heart Failure Clinic. Results: Thirty-five pts were included, median age 59 [interquartile range (28,63)], 24 (69%) men. Most pts (53%) were in NYHA class I and 34 (95%) had preserved LV ejection fraction; transmitral inflow pattern data were available in 27 pts --diastolic dysfunction was present in 41% (type I, II and III in 6, 4 and 1 pts, respectively). Seven (20%) pts had 25OHD insufficiency [2065 pg/mL). 25OHD deficiency was significantly associated with higher LV mass index (213 ± 55 vs 158 ± 44 g/m2, p=0.018) and with higher probability of familiar sudden cardiac death (SCD) (52 vs 17%,p=0.043). Also, pts using diuretics had lower levels of serum 25OHD [12(10,13) vs 16(13,26) ng/mL, p=0.025]. PTH levels were positively correlated with age, number of SCD risk factors, BNP and reactive C-protein levels and inversely correlated with metabolic equivalents on treadmill stress test (p < 0.05 for all analysis). PTH excess was significantly associated with non-sustained ventricular tachycardia on Holter monitoring (55 vs 20%, p=0.049), mitral regurgitation (100 vs 54%, p=0.007) and use of diuretics (36 vs 6%, p=0.016). Also, higher levels of serum PTH were found in pts with atrial fibrillation when compared with pts in sinus rhythm [88(63,94) vs 47(28,68) pg/mL, p=0.03] and in pts with diastolic dysfunction [67(48,88) vs 33(26,51) pg/mL, p=0.002]. No relations were found with NYHA class, systolic LV function and late-enhancement in MR. Conclusion: Among MCH pts, 25OHD deficiency was very frequent and almost one third presented PTH excess. These abnormalities were significantly associated with parameters of worse prognosis in these pts. 25OHD and PTH might influence HMC pathogenesis and further studies are needed to assess their exact role.

Language: English

Type (Professor's evaluation): Scientific

Notes: Sousa A. Lebreiro A, Martins E, Sousa C, Paiva, Campelo M, Amorim S, Moura B, Silva Cardoso J, Maciel M J. Vitamin D, Parathyroid Hormone and Hypertrophic Myocardiopathy. Eur J Heart Fail Suppl 2012; 11(Suppl 1): P250. ISSN 1567-4215 Heart Failure Congress 2012, Belgrade, 2012