natriuretic-peptide--brain and Pseudohypoparathyroidism

Cardiac damage triggered by severe hypocalcemia is well known. However, the role of chronic hypoparathyroidism (HP) and pseudohypoparathyroidism (PHP) in cardiac health is still unclear. We investigated the effect of chronic HP and PHP on cardiac structure and conductive function in patients compiling with treatment.. The study included 18 patients with HP and eight with PHP aged 45.4 ± 15.4 and 22.1 ± 6.4 years, respectively with a previously regular follow-up. In addition, 26 age- and sex-matched healthy controls were included. General characteristics and biochemical indices were recorded. Cardiac function and structure were assessed by estimation of myocardial enzymes, B-type natriuretic peptide (BNP), and echocardiography. The 12-lead electrocardiogram and 24-h Holter electrocardiography were performed to evaluate the conductive function.. Levels of serum calcium in HP and PHP were 2.05 ± 0.16 mmol/L and 2.25 ± 0.19 mmol/L, respectively. The levels of myocardial enzyme and BNP were within the normal range. Adjusting for age at evaluation and body mass index, all M-mode measurements, left ventricular mass (LVM), LVM index (LVMI) and relative wall thickness (RWT) were comparable between patients and controls. Prolongation of corrected QT (QTc) intervals occurred in 52.6% (10/19) of patients, and 6.7% (1/15) of patients manifested more than 100 episodes of supraventricular and ventricular extrasystoles, as well as supraventricular tachycardia. None of the above arrhythmias was related to a severe clinical event.. From this pilot study, patients diagnosed with HP and PHP and well-controlled serum calcium levels manifested normal cardiac morphology and ventricular function, except for prolonged QTc intervals, and a small percentage of mild arrhythmias needing further investigation.

Topics: Adolescent; Adult; Arrhythmias, Cardiac; Atrial Premature Complexes; Calcium; Case-Control Studies; Chronic Disease; Echocardiography; Electrocardiography; Electrocardiography, Ambulatory; Female; Humans; Hypoparathyroidism; Long QT Syndrome; Male; Middle Aged; Natriuretic Peptide, Brain; Pilot Projects; Pseudohypoparathyroidism; Tachycardia, Supraventricular; Ventricular Dysfunction, Left; Ventricular Premature Complexes; Young Adult

Hypocalcemic cardiomyopathy is a rare entity. We describe a patient with severe heart failure, decreased ejection fraction and global hypokinesia documented on echocardiogram, associated with severe hypocalcemia, very low vitamin D status, increased QT intervals, increased BNP (serum brain natriuretic peptide) levels and CPK (creatine phosphokinase) levels. All these defects reversed on treatment with vitamin D and calcium within a few days without any specific cardiac intervention.

Topics: Aged; Calcium; Cardiomyopathies; Creatine Kinase; Echocardiography; Heart Failure; Humans; Hypocalcemia; Hypokinesia; Natriuretic Peptide, Brain; Pseudohypoparathyroidism; Treatment Outcome; Vitamin D; Vitamin D Deficiency; Vitamins