Abstract：
OBJECTIVE: To investigate the occurrence of arrhythmias in patients with normocalcemic (NC) primary hyperparathyroidism (PHPT) compared to both hypercalcemic PHPT patients and control subjects by means of 24-h Holter ECG.
METHODS: Thirteen NCPHPT postmenopausal patients were enrolled and age-matched with 13 hypercalcemic PHPT patients and 13 controls. Every subject underwent basal ECG, 24-h Holter ECG and mineral metabolism biochemical evaluation.
RESULTS: PHPT patients had higher mean serum calcium levels compared to both NCPHPT and controls; there was no difference in mean serum calcium levels between NCPHPT and controls. Both NCPHPT and PHPT patients had significantly higher mean PTH levels compared with controls. There were no differences in ECG parameters between the three groups, except for QTc interval. PHPT patients had normal QTc interval values, but significantly shorter mean values compared with those of controls and NCPHPT patients. During 24-h Holter ECG recording, 100% of PHPT patients had supraventricular premature beats (SVPBs), compared to 46% of NCPHPT (p = 0.005) and to 53% of controls (p = 0.01). PHPT patients experienced ventricular premature beats (VPBs) (69.2%) vs 15% of NCPHPT patients (p = 0.01) and 23% of controls (p = 0.04). There was no difference between NCPHPT and controls subjects concerning occurrence of both VPBs and SVPBs.
CONCLUSIONS: NCPHPT patients did not experience an increased occurrence of arrhythmias compared to controls, while PHPT patients showed an increased occurrence compared to both controls and NCPHPT. Our findings are most probably related to the short QTc interval caused by hypercalcemia observed in PHPT patients, but not in NCPHPT.
METHODS: Thirteen NCPHPT postmenopausal patients were enrolled and age-matched with 13 hypercalcemic PHPT patients and 13 controls. Every subject underwent basal ECG, 24-h Holter ECG and mineral metabolism biochemical evaluation.
RESULTS: PHPT patients had higher mean serum calcium levels compared to both NCPHPT and controls; there was no difference in mean serum calcium levels between NCPHPT and controls. Both NCPHPT and PHPT patients had significantly higher mean PTH levels compared with controls. There were no differences in ECG parameters between the three groups, except for QTc interval. PHPT patients had normal QTc interval values, but significantly shorter mean values compared with those of controls and NCPHPT patients. During 24-h Holter ECG recording, 100% of PHPT patients had supraventricular premature beats (SVPBs), compared to 46% of NCPHPT (p = 0.005) and to 53% of controls (p = 0.01). PHPT patients experienced ventricular premature beats (VPBs) (69.2%) vs 15% of NCPHPT patients (p = 0.01) and 23% of controls (p = 0.04). There was no difference between NCPHPT and controls subjects concerning occurrence of both VPBs and SVPBs.
CONCLUSIONS: NCPHPT patients did not experience an increased occurrence of arrhythmias compared to controls, while PHPT patients showed an increased occurrence compared to both controls and NCPHPT. Our findings are most probably related to the short QTc interval caused by hypercalcemia observed in PHPT patients, but not in NCPHPT.
摘要：
目的：通过24小时动态心电图，比较正常血钙（NC）原发性甲状旁腺功能亢进（PHPT）患者与高钙血PHPT患者和对照组患者的心律失常发生情况。
方法：纳入13例NCPHPT绝经后患者，年龄匹配13例高钙血症PHPT患者和13例对照。每个受试者都接受了基础心电图,24小时动态心电图和矿物质代谢生化评价。
结果：PHPT患者的平均血清钙水平高于NCPHPT和对照组；NCPHPT和对照组之间的平均血清钙水平没有差异。与对照组相比，NCPHPT和PHPT患者的平均PTH水平均显着较高。三组间心电图参数无差异,除了QTc间隔。PHPT患者QTc间期值正常,但与对照组和NCPHPT患者相比，平均值明显较短。在24小时动态心电图记录期间，100%的PHPT患者有室上性早搏(SVPBs),与NCPHPT的46％（p=0.005）和对照组的53％（p=0.01）相比。PHPT患者发生室性早搏（VPBs）（69.2％），NCPHPT患者为15％（p=0.01），对照组为23％（p=0.04）。NCPHPT和对照组之间关于VPB和SVPB的发生没有差异。
结论：与对照组相比，NCPHPT患者的心律失常发生率并未增加，而与对照组和NCPHPT相比，PHPT患者的发生率增加。我们的发现很可能与在PHPT患者中观察到的高钙血症引起的短QTc间隔有关。但不是在NCPHPT。
方法：纳入13例NCPHPT绝经后患者，年龄匹配13例高钙血症PHPT患者和13例对照。每个受试者都接受了基础心电图,24小时动态心电图和矿物质代谢生化评价。
结果：PHPT患者的平均血清钙水平高于NCPHPT和对照组；NCPHPT和对照组之间的平均血清钙水平没有差异。与对照组相比，NCPHPT和PHPT患者的平均PTH水平均显着较高。三组间心电图参数无差异,除了QTc间隔。PHPT患者QTc间期值正常,但与对照组和NCPHPT患者相比，平均值明显较短。在24小时动态心电图记录期间，100%的PHPT患者有室上性早搏(SVPBs),与NCPHPT的46％（p=0.005）和对照组的53％（p=0.01）相比。PHPT患者发生室性早搏（VPBs）（69.2％），NCPHPT患者为15％（p=0.01），对照组为23％（p=0.04）。NCPHPT和对照组之间关于VPB和SVPB的发生没有差异。
结论：与对照组相比，NCPHPT患者的心律失常发生率并未增加，而与对照组和NCPHPT相比，PHPT患者的发生率增加。我们的发现很可能与在PHPT患者中观察到的高钙血症引起的短QTc间隔有关。但不是在NCPHPT。
