• Eur. J. Clin. Invest. · Feb 2013

    Arrhythmias in primary hyperparathyroidism evaluated by exercise test.

    • Jessica Pepe, Mario Curione, Sergio Morelli, Marco Colotto, Marisa Varrenti, Claudia Castro, Antonella D'Angelo, Cristiana Cipriani, Sara Piemonte, Elisabetta Romagnoli, and Salvatore Minisola.
    • Department of Internal Medicine and Medical Disciplines, Sapienza University of Rome, 00161 Rome, Italy. jesspepe@tin.it
    • Eur. J. Clin. Invest. 2013 Feb 1; 43 (2): 208-14.

    BackgroundHypercalcemia 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).MethodsThirty 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 (QTc).ResultsCompared with controls, PHPT patients showed an increased occurrence of ventricular premature beats (VPBs) during ET (26·6% vs. 6·6%, P = 0·03). Being affected by PHPT predicted the onset of VPBs 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 VPBs at peak exercise (P = 0·05). QTc in patients with PHPT was in the normal range. Serum calcium level showed a negative correlation with QTc (P = 0·01) in whole sample. Compared with controls, PHTP patients had QTc significantly shorter for every stage of ET, except at peak exercise. Physiological reduction of QTc interval from rest to peak exercise was not seen in patients with PHPT, QTc at rest being the only predictor of QTc in every stage, as shown by multivariate regression analysis.ConclusionsIn patients with PHPT, an increased occurrence of VPBs and a different QTc adaptation during ET were observed and may represent risk factors for major arrhythmias.© 2012 The Authors. European Journal of Clinical Investigation © 2012 Stichting European Society for Clinical Investigation Journal Foundation.

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