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Interrelationship between haemodynamic state and serum intact parathyroid hormone levels in patients with chronic heart failure
  1. Tadafumi Sugimoto1,
  2. Kaoru Dohi2,
  3. Katsuya Onishi1,
  4. Kiyotaka Watanabe1,
  5. Yuichi Sato1,
  6. Emiyo Sugiura1,
  7. Shiro Nakamori1,
  8. Hiroshi Nakajima1,
  9. Mashio Nakamura3,
  10. Masaaki Ito1
  1. 1Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
  2. 2Department of Molecular and Laboratory Medicine, Mie University Graduate School of Medicine, Tsu, Japan
  3. 3Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine, Tsu, Japan
  1. Correspondence to Dr Tadafumi Sugimoto, Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Japan; t_sugimoto_japan{at}hotmail.com

Abstract

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/m2, r=−0.52, p<0.05) and cardiac index (2.6±0.7 l/min/m2, 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.

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