ABSTRACT
Parathyroid hormone [PTH] regulates the content of calcium and exerts an effect on myocardial function. Abnormal secretion of PTH has been sporadically reported to be associated with depressed mechanical performance of the heart muscle. The aim of this study is to evaluate parathyroid function in patients with CHF due to dilated cardiomyopathy [DCM], measuring some different parameters of calcium metabolism This work was carried on 30 cases [20 males and 10 females] with congestive heart failure [CHF] having a mean age of 6.69 +/- 3.94 years. They were recruited from Cardiomyopathy Clinic at Cairo University Children Hospital [Abou El Riche], All our patients were subjected to full history taking, general examination and echo-cardiographic examinations. Thirty normal healthy children of matched age and sex were included to serve as control. Cases were further classified into[i] Decompensated HF[n=18] [NYHA III, IV] who were admitted to in patient units and[ii] Compensated HF[n=12] [NYHA II]. The following laboratory parameters were measured and compared. Osteocalcin[OC] and Parathyroid hormone[PTH], in addition to total serum calcium, phosphorus, creatinine, urea, alkaline phosphatase, sodium and potassium. The results of our work revealed statistically significant lower serum calcium, higher serum phosphorus levels and lower serum osteocalcin in DCM cases compared to controls [p=0.0001,0.002 and 0.0001 respectively].There was no statistically significant difference between cases and controls regarding serum PTH. l.e. normal PTH, however the calcium is depressed in DCM. Parathyroid hormone level was normal in patients with CHF, however three cases of the decompenstated group showed non-significant elevated levels. Significant hypocalcaemia, hyperphosphatemia and reduction in serum OC levels were noted in our CHF patients. Further studies of these factorscontributing to the associated morbidity of patients with decompensated CHF-should be well traced