Parathormone and left ventricular hypertrophy]

In order to examine the relation between secondary hyperparathyroidism (sHPT) and left ventricular hypertrophy (LVH) in hemodialysis (HD) patients, were selected retrospectively 60 of 228 HD patients who had two echocardiography over a 12-16 months period (13.2 1.2 months). Patients were subdivided in three groups (G) according to PTH behaviour: G1 (n = 19), with PTH levels < 300 pg/ml not requiring with vitamin D receptor activators (VDRAs) treatment; G2 (n = 20), with a progressive increase of PTH levels to values > 300 pg/ml that required to start or to increase VDRAs therapy in 18/20 patients during follow-up; G3 (n = 21), with PTH levels > 300 pg/ml and > 50% reduction after VDRAs treatment. Parathormone levels correlated with left ventricular mass index (LVMi; r = 0.714; P < 0.001). Multiple regression analysis indicated that PTH levels were an independent predictor of LVMi (P < 0.001). Patients with baseline PTH levels > 300 pg/ml (n = 27) had higher LVMi with respect to those with PTH < 300 pg/ml (n=33), 197 50 vs 136 30 g/m2 (P < 0.01). In G1 LVMi did not change during follow-up. In G2 LVMi increased from 146 26 to 169 35 g/m2 (P=NS). In G3LVMi decreased from 210 44 to 154 42 g/m2 (P < 0.05). Parathyroid hormone seems to play an important role in the genesis and perpetuation of LVH, whereas treatment of sHPT with VDRAs may determine LVH regression or at least slow down its progression.