Restored Cardiac Conditions and Left Ventricular Function After Parathyroidectomy in a Hemodialysis Patient Parathyroidectomy Improves Cardiac Fatty Acid Metabolism Assessed by 123I-BMIPP

Nanasato, Mamoru; Goto, Norihiko; Isobe, Satoshi; Unno, Kazumasa; Hanawa, Haruo; Sato, Tetsuhiko; Matsuoka, Susumu; Nagasaka, Takaharu; Tominaga, Yoshihiro; Uchida, Kazuharu; Murohara, Toyoaki

doi:10.1253/circj.cj-08-0415

Cited by 14 publications

(10 citation statements)

References 21 publications

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“…As a matter of fact, several lines of evidence suggested PTX improved cardiac function and relieved vascular calcification . Other possible reasons for improving outcomes include reduction risk of fracture, improvement of immune system and cardiac function . Recently, an observational study from the USRDS demonstrated that PTX is associated with improved survival .…”

Section: Discussionmentioning

confidence: 99%

Impact of parathyroidectomy on survival among haemodialysis patients: A prospective cohort study

Zhang

et al. 2016

Nephrology

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Section: Discussionmentioning

confidence: 99%

Impact of parathyroidectomy on survival among haemodialysis patients: A prospective cohort study

Zhang

et al. 2016

Nephrology

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“…Very few studies have addressed the effects of parathyroidectomy on BNP level and have had conflicting results. There was a case report on a woman with remarkable improvement in left ventricular contraction after parathyroidectomy (22). Along with the decrease in PTH level, the patient's BNP level dropped from 5,790 to 1,250 pg/ml at 6 months after the operation.…”

Section: Discussionmentioning

confidence: 96%

Increasing Age Hinders the Decline in B-Type Natriuretic Peptide Following Parathyroidectomy in Dialysis Patients

Chu

Yang

Lee

et al. 2019

In Vivo

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Background/Aim: Parathyroidectomy has beneficial effects on all-cause and cardiovascular mortality in patients with uncontrolled hyperparathyroidism. B-Type natriuretic peptide (BNP) correlates with the severity of heart failure. We aimed to investigate whether parathyroidectomy modulates the BNP levels in dialysis patients. Patients and Methods: Patients who underwent surgical intervention for hyperparathyroidism were included. The serum BNP levels were determined before parathyroidectomy and during follow-up. Results: The preoperative and postoperative BNP levels were 499±561 and 453±442 pg/ml, respectively (p=0.82). The baseline BNP level was positively correlated with weakness and headache, but not biochemical parameters. In multivariate analysis, age (odds ratio=0.837) and preoperative symptom score (odds ratio=0.935) were independent predictors for the postoperative decline in BNP levels Conclusion: The serum BNP levels may increase or decrease after parathyroidectomy. Younger age and lower symptom burden are associated with decline in BNP levels.

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“…PTH activates fibroblasts and regulates pro‐fibrotic molecules such as aldosterone and angiotensin II , and has been shown to activate transforming growth factor‐beta (TGF‐β), which contributes to proliferation of fibroblasts, collagen synthesis and fibrosis . A case report of a hemodialysis patient showed that, in parallel with LV contraction, disturbance of cardiac fatty acid metabolism observed by myocardial BMIPP imaging was improved by parathyroidectomy . This suggests involvement of high PTH levels in cardiac dysfunction in a clinical setting.…”

Section: Discussionmentioning

confidence: 99%

Myocardial SPECT Images in Incident Hemodialysis Patients Without Ischemic Heart Disease

et al. 2015

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Cardiovascular disease is the leading cause of death in dialysis patients and is significantly associated with poor survival in incident dialysis patients. However, little is known about the pathogenesis of cardiovascular disease in these populations. (123) I-15-(p-iodophenyl)-3(R,S)- methylpentadecanoic acid (BMIPP) imaging is useful for detection of ischemic heart disease. We examined imaging characteristics to identify potential pathologies of cardiac disease, other than ischemic heart disease. The subjects were 42 incident dialysis patients without histories of ischemic heart disease such as acute coronary syndrome. All the patients underwent BMIPP imaging in addition to a screening examination. Patients with positive findings in BMIPP imaging underwent myocardial perfusion imaging within 2 weeks after BMIPP imaging to evaluate the possibility of ischemic heart disease. Twenty-two patients were BMIPP-positive and 10 of these patients had negative findings on perfusion imaging and were defined as mismatch cases. Compared with patients who were BMIPP- and perfusion-positive, the mismatch cases had higher parathyroid hormone (PTH), serum albumin, and alkaline phosphatase levels. The mismatch cases also formed the largest proportion in the highest PTH tertile. A histologic examination of a mismatch case with no stenotic lesions in the coronary artery revealed the presence of cardiac hypertrophy and fibrosis. These findings suggest that a perfusion-metabolism mismatch may be present in incident dialysis patients without a history of ischemic heart disease. This mismatch is associated with PTH, which suggests potential involvement of uremic cardiomyopathy in the pathology of cardiac disease in these patients.

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Restored Cardiac Conditions and Left Ventricular Function After Parathyroidectomy in a Hemodialysis Patient Parathyroidectomy Improves Cardiac Fatty Acid Metabolism Assessed by 123I-BMIPP

Cited by 14 publications

References 21 publications

Impact of parathyroidectomy on survival among haemodialysis patients: A prospective cohort study

Impact of parathyroidectomy on survival among haemodialysis patients: A prospective cohort study

Increasing Age Hinders the Decline in B-Type Natriuretic Peptide Following Parathyroidectomy in Dialysis Patients

Myocardial SPECT Images in Incident Hemodialysis Patients Without Ischemic Heart Disease

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