The effect of surgical cure of primary hyperparathyroidism on cardiac electrical activity: a cross−sectional study

Cardiovascular complications are not assessed routinely in the management of primary hyperparathyroidism (pHPT), nor do they constitute indications for surgical treatment of this disorder. Research concerning the effects on cardiac electrical activity in PHPT is scarce. In the current study, 45 cons...

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Main Authors: Piotr Kmieć, Izabela Karwacka-Bujak, Michał Bohdan, Renata Świątkowska-Stodulska, Krzysztof Sworczak
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1601897/full
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author Piotr Kmieć
Piotr Kmieć
Izabela Karwacka-Bujak
Izabela Karwacka-Bujak
Michał Bohdan
Renata Świątkowska-Stodulska
Renata Świątkowska-Stodulska
Krzysztof Sworczak
Krzysztof Sworczak
author_facet Piotr Kmieć
Piotr Kmieć
Izabela Karwacka-Bujak
Izabela Karwacka-Bujak
Michał Bohdan
Renata Świątkowska-Stodulska
Renata Świątkowska-Stodulska
Krzysztof Sworczak
Krzysztof Sworczak
author_sort Piotr Kmieć
collection DOAJ
description Cardiovascular complications are not assessed routinely in the management of primary hyperparathyroidism (pHPT), nor do they constitute indications for surgical treatment of this disorder. Research concerning the effects on cardiac electrical activity in PHPT is scarce. In the current study, 45 consecutive pHPT patients with hypercalcemia and elevated parathyroid hormone levels were assessed clinically, biochemically and by 24-h ECG monitoring before, one and six months after curative parathyroidectomy (PTX). There were 41 female and four male subjects, their mean age was 54.6 ± 14.6 years. 20 patients were normotensive and 25 had previously or newly diagnosed hypertension. Patients without hypertension compared to the hypertensive ones had lower BMI: 23.2 (20.3-25.4) versus 26.7 (24.8-28.4), higher total calcium: 11.9 ± 0.8 versus 11.3 ± 0.9 mg/dL, and shorter QTc: 418 ± 17 versus 436 ± 17 ms, p<0.001. Before surgery, Ca and PTH correlated negatively with QTc. Upon curative PTX, the median number of supraventricular premature beats (SVPBs) and ventricular premature beats (VPBs) decreased significantly, which was paralleled by a 37% decrease in the prevalence of clinically significant SVPBs (>76 per 24h), and a 29% decrease in the number of patients with more than 3 VPBs/24h six months after surgery. QTc increased from 428 ± 19 before to 441 ± 17 ms after PTX. The change in the median number of SVPBs and VPBs was comparable between patients with versus without HT. Curative PTX normalizes QTc, reduces supraventricular and ventricular extrasystoles in patients with hypercalcemic pHPT.
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spelling doaj-art-c48b4c337b95461da77a7bd0e37186542025-08-20T03:14:02ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-07-011610.3389/fendo.2025.16018971601897The effect of surgical cure of primary hyperparathyroidism on cardiac electrical activity: a cross−sectional studyPiotr Kmieć0Piotr Kmieć1Izabela Karwacka-Bujak2Izabela Karwacka-Bujak3Michał Bohdan4Renata Świątkowska-Stodulska5Renata Świątkowska-Stodulska6Krzysztof Sworczak7Krzysztof Sworczak8Department of Endocrinology and Internal Medicine, Medical University of Gdańsk, Gdańsk, PolandDepartment of Endocrinology and Internal Medicine, University Clinical Center, Gdańsk, PolandDepartment of Endocrinology and Internal Medicine, Medical University of Gdańsk, Gdańsk, PolandDepartment of Endocrinology and Internal Medicine, University Clinical Center, Gdańsk, Poland1st Department of Cardiology, Medical University of Gdańsk, Gdańsk, PolandDepartment of Endocrinology and Internal Medicine, Medical University of Gdańsk, Gdańsk, PolandDepartment of Endocrinology and Internal Medicine, University Clinical Center, Gdańsk, PolandDepartment of Endocrinology and Internal Medicine, Medical University of Gdańsk, Gdańsk, PolandDepartment of Endocrinology and Internal Medicine, University Clinical Center, Gdańsk, PolandCardiovascular complications are not assessed routinely in the management of primary hyperparathyroidism (pHPT), nor do they constitute indications for surgical treatment of this disorder. Research concerning the effects on cardiac electrical activity in PHPT is scarce. In the current study, 45 consecutive pHPT patients with hypercalcemia and elevated parathyroid hormone levels were assessed clinically, biochemically and by 24-h ECG monitoring before, one and six months after curative parathyroidectomy (PTX). There were 41 female and four male subjects, their mean age was 54.6 ± 14.6 years. 20 patients were normotensive and 25 had previously or newly diagnosed hypertension. Patients without hypertension compared to the hypertensive ones had lower BMI: 23.2 (20.3-25.4) versus 26.7 (24.8-28.4), higher total calcium: 11.9 ± 0.8 versus 11.3 ± 0.9 mg/dL, and shorter QTc: 418 ± 17 versus 436 ± 17 ms, p<0.001. Before surgery, Ca and PTH correlated negatively with QTc. Upon curative PTX, the median number of supraventricular premature beats (SVPBs) and ventricular premature beats (VPBs) decreased significantly, which was paralleled by a 37% decrease in the prevalence of clinically significant SVPBs (>76 per 24h), and a 29% decrease in the number of patients with more than 3 VPBs/24h six months after surgery. QTc increased from 428 ± 19 before to 441 ± 17 ms after PTX. The change in the median number of SVPBs and VPBs was comparable between patients with versus without HT. Curative PTX normalizes QTc, reduces supraventricular and ventricular extrasystoles in patients with hypercalcemic pHPT.https://www.frontiersin.org/articles/10.3389/fendo.2025.1601897/fullprimary hyperparathyroidismparathyroidectomyhypertensionpremature cardiac complexeselectrocardiography
spellingShingle Piotr Kmieć
Piotr Kmieć
Izabela Karwacka-Bujak
Izabela Karwacka-Bujak
Michał Bohdan
Renata Świątkowska-Stodulska
Renata Świątkowska-Stodulska
Krzysztof Sworczak
Krzysztof Sworczak
The effect of surgical cure of primary hyperparathyroidism on cardiac electrical activity: a cross−sectional study
Frontiers in Endocrinology
primary hyperparathyroidism
parathyroidectomy
hypertension
premature cardiac complexes
electrocardiography
title The effect of surgical cure of primary hyperparathyroidism on cardiac electrical activity: a cross−sectional study
title_full The effect of surgical cure of primary hyperparathyroidism on cardiac electrical activity: a cross−sectional study
title_fullStr The effect of surgical cure of primary hyperparathyroidism on cardiac electrical activity: a cross−sectional study
title_full_unstemmed The effect of surgical cure of primary hyperparathyroidism on cardiac electrical activity: a cross−sectional study
title_short The effect of surgical cure of primary hyperparathyroidism on cardiac electrical activity: a cross−sectional study
title_sort effect of surgical cure of primary hyperparathyroidism on cardiac electrical activity a cross sectional study
topic primary hyperparathyroidism
parathyroidectomy
hypertension
premature cardiac complexes
electrocardiography
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1601897/full
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