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Arrhythmias in primary hyperparathyroidism evaluated by exercise test
Author(s) -
Pepe Jessica,
Curione Mario,
Morelli Sergio,
Colotto Marco,
Varrenti Marisa,
Castro Claudia,
D'Angelo Antonella,
Cipriani Cristiana,
Piemonte Sara,
Romagnoli Elisabetta,
Minisola Salvatore
Publication year - 2013
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12038
Subject(s) - medicine , primary hyperparathyroidism , qt interval , cardiology , logistic regression , hyperparathyroidism , electrocardiography , heart rate , endocrinology , blood pressure
Background Hypercalcemia induces arrhythmias and shortening of QT . The aim of this study was to investigate risk factors for occurrence of arrhythmias in patients with primary hyperparathyroidism ( PHPT ) during bicycle ergometer exercise test ( ET ). Methods Thirty PHPT postmenopausal women (mean age, 60·9 ± 8·0 years) and 30, sex and age‐matched, controls underwent ET , echocardiogram and mineral metabolism biochemical evaluation. The following stages were considered during ET : rest, peak exercise, recovery (early recovery, 2 and 10 min after peak exercise). QT was corrected with Bazett's formula ( QT c). Results Compared with controls, PHPT patients showed an increased occurrence of ventricular premature beats ( VPB s) during ET (26·6% vs. 6·6%, P = 0·03). Being affected by PHPT predicted the onset of VPB s at peak exercise ( P = 0·04) and recovery ( P = 0·03), as shown by logistic regression analysis. In PHPT patients, serum calcium level was a predictor of VPB s at peak exercise ( P = 0·05). QT c in patients with PHPT was in the normal range. Serum calcium level showed a negative correlation with QT c ( P = 0·01) in whole sample. Compared with controls, PHTP patients had QT c significantly shorter for every stage of ET , except at peak exercise. Physiological reduction of QT c interval from rest to peak exercise was not seen in patients with PHPT , QT c at rest being the only predictor of QT c in every stage, as shown by multivariate regression analysis. Conclusions In patients with PHPT , an increased occurrence of VPB s and a different QT c adaptation during ET were observed and may represent risk factors for major arrhythmias.