A cross-sectional observational study of serum parathyroid hormone levels and its relation with severity and duration of heart failure
Keywords:
Serum PTH, Serum calcium, NYHA grade, Ejection Fraction, Duration of Heart failure.Abstract
Background: Congestive Heart Failure is a systemic illnesscharacterized by neuro-endocrine immune system dysregulation, oxidative stress, release of proinflammatory cytokines leading to a catabolic state and secondary hyperparathyroidism. Abnormal elevation of serum PTH leads to excessive intracellularcalcium accumulation in cardiomyocytes leading to myocyte necrosis, replacementfibrosis and contributes to progressive heart failure. Objectives: To study the levels of serum PTH in patients of congestivecardiac failure and to establish the relation of serum PTH with duration and severity of heart failure.Methods: The study was conducted on 50 patients diagnosed to have CCF on the basis of symptoms, clinicalexamination, NYHA grading and 2-D Echocardiography. SerumPTH was measured by chemiluminescence and its correlation with severity and duration of heart failure was analysed statistically. Results: Among the patients studied, 56% of the patients with EF ≤ 35% hadelevated serum PTH levels(Mean: 70.1±14.6 pg/ml, p<0.001). 56% in the NYHA functionalclassification Grade III had elevated serum PTH levels (Mean: 69.8±14.73pg/ml, p<0.001). 60.9% ofpatients with duration of heart failure >2 years had elevated serum PTH levels>72pg/ml (p< 0.001). Conclusion: There was a significant positive correlation ofserum parathyroid hormone levels with the duration and negative correlation withseverity of heart failure as measured by ejection fraction. Therefore, serum PTH levels can be used as an individualprognostic marker to assess the severity of heart failure.