Assessment of Speckle-Tracking Echocardiography in Primary Hyperparathyroidism

Abstract

Objective: Primary hyperparathyroidism (PHPT) has been associated with increased cardiovascular morbidity and mortality. Although conventional echocardiography is frequently used to evaluate cardiac function, it may fail to detect early myocardial changes. Speckle-tracking echocardiography (STE) provides greater sensitivity in identifying subclinical cardiac dysfunction. This study investigated systolic and diastolic functions of the left ventricle (LV) using STE in PHPT patients and examined their associations with clinical and biochemical variables. Methods: A total of 39 PHPT patients and 40 healthy controls were enrolled. PHPT diagnosis was based on elevated serum calcium and parathormone (PTH) levels, confirmed by imaging. Patients with comorbid conditions such as hypertension, diabetes, and chronic kidney disease were excluded. All individuals of patient and control groups were performed both conventional echocardiography and STE. Global longitudinal strain (GLS) and additional parameters of echocardiographic investigation were measured. Biochemical assessments included serum calcium level, phosphorus, 25-hydroxy vitamin D, and PTH levels. Statistical comparisons and correlation analyses were performed. Results: PHPT patients showed higher calcium, parathormone levels, and lower phosphorus and vitamin D levels than controls. GLS values were considerably lower in the PHPT group, indicating subclinical myocardial dysfunction despite intact ejection fraction (p < 0.05). GLS and levels of calcium, phosphorus, and PTH were found to be significantly correlated (p < 0.05). Conclusion: STE effectively detected early myocardial dysfunction in PHPT patients and demonstrated associations with biochemical markers. These results support the use of STE for early cardiac assessment in PHPT and underline the need for further studies to confirm these findings.