RESUMO
BACKGROUND: Parathyroid hormone (PTH) is a novel promising biomarker that can predict hospitalization, functional status and mortality in patients who suffered heart failure with preserved ejection fraction (HFpEF). OBJECTIVE: We aimed to investigate the association of serum PTH levels and measures of disease severity (NYHA functional class, NT-proBNP, CRP, EF, Troponin I) in patients with HFpEF. METHODS: A total of consecutive 58 outpatients with HFpEF and 30 controls were prospectively studied. All patients underwent laboratory tests, including NT-proBNP and PTH analyses. RESULTS: PTH, NT-proBNP, troponin I, and CRP levels were significantly higher in patients with HFpEF when compared with control group (54.61 ± 31.02 vs 40.40 ± 14.22 pg/ml, p < 0.05; 126.05 ± 162.94 vs 44.57 ± 14.95 pg/ml, p < 0.01; 0.011 ± 0.013 vs 0.004 ± 0.001 ug/L, p < 0.01; 4.65 ± 4.24 vs 1.63 ± 0.97 mg/L, p < 0.01, respectively). Left atrium was found to be more enlarged in HFpEF patients (LAVI = 36 ± 18 vs 28 ± 11 ml/m², p < 0.01). Most indices of left ventricular diastolic function were more severely impaired compared to controls (p < 0.05). There was no correlation between PTH and CRP, troponin I, LVMI, LV volumes, LV diameters, E/E', age, and BMI in both groups (p = NS). There was strong positive correlation between PTH and NT-proBNP levels in all study participants (r = 0.359; p < 0.01). CONCLUSION: PTH together with other markers of heart failure may provide valuable information both in the diagnosis and staging of heart failure syndromes (Tab. 4, Fig. 1, Ref. 40).
Assuntos
Proteína C-Reativa/análise , Insuficiência Cardíaca/diagnóstico por imagem , Peptídeo Natriurético Encefálico/sangue , Hormônio Paratireóideo/sangue , Fragmentos de Peptídeos/sangue , Volume Sistólico/fisiologia , Troponina I/sangue , Idoso , Biomarcadores/sangue , Estudos de Casos e Controles , Diástole , Ecocardiografia Tridimensional , Feminino , Insuficiência Cardíaca/sangue , Insuficiência Cardíaca/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Índice de Gravidade de Doença , Função Ventricular Esquerda/fisiologiaAssuntos
Aorta/anormalidades , Aorta/patologia , Coartação Aórtica/diagnóstico , Valva Aórtica/anormalidades , Valva Aórtica/patologia , Doenças das Valvas Cardíacas/diagnóstico , Adolescente , Doença da Válvula Aórtica Bicúspide , Diagnóstico Diferencial , Dilatação Patológica/diagnóstico , Ecocardiografia/métodos , Humanos , Angiografia por Ressonância Magnética/métodos , MasculinoAssuntos
Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/patologia , Septos Cardíacos/patologia , Mixoma/complicações , Mixoma/patologia , Estenose da Valva Tricúspide/diagnóstico , Estenose da Valva Tricúspide/etiologia , Adolescente , Feminino , Átrios do Coração/patologia , Átrios do Coração/cirurgia , Neoplasias Cardíacas/cirurgia , Humanos , Mixoma/cirurgia , Invasividade Neoplásica , Resultado do Tratamento , Estenose da Valva Tricúspide/cirurgiaRESUMO
Takotsubo cardiomyopathy (TTC) is an acute cardiac syndrome characterized by transient regional wall motion abnormalities of the left ventricular apex or midventricle. Patients often present with chest pain or dyspnea, ST-segment elevation, and minor elevation of cardiac enzyme levels. TTC has been associated with severe emotional or physical stress such as severe burns, spinal cord injury, subarachnoid hemorrhage, multiple traumas, and surgery. We report a case of TTC in a 45-year-old woman who had undergone appendectomy 2 days before presenting to our institution.
