Objective: To assess the impact of serum intact parathyroid hormone (PTH) levels on haemodynamic state and their relations by comparing plasma B-type natriuretic peptide (BNP) levels.
Design: Cross-sectional study in molecular epidemiology.
Setting: Mie University Hospital, Tsu, Japan.
Patients: Consecutive 105 patients with chronic heart failure (CHF).
Main outcome measures: Serum intact PTH and plasma BNP levels were assessed simultaneously with right heart catheterisation.
Results: Although serum intact PTH levels (46±25 pg/ml) were within the normal range (<65 pg/ml) in 87% of patients, log-transformed intact PTH levels significantly correlated with pulmonary capillary wedge pressure (PCWP: 15±9 mm Hg, r=0.55, p<0.05) and heart rate (73±14/min, r=0.40, p<0.05), whereas log-transformed intact PTH levels were inversely correlated with stroke volume index (SVI: 38±11 ml/m(2), r=-0.52, p<0.05) and cardiac index (2.6±0.7 l/min/m(2), r=-0.41, p<0.05) in all patients. PCWP and SVI were independent determinants of log-transformed intact PTH levels (β=0.40 and -0.37, p<0.05, respectively) after adjusting for variables associated with PTH. Conversely, after adjusting for variables associated with CHF, log-transformed intact PTH levels were an independent determinant of PCWP, SVI, heart rate and cardiac index (β=0.38, -0.33, 0.32, and -0.25, p<0.05, respectively), and might be defined as a superior determinant of SVI and cardiac index compared with log-transformed BNP levels using stepwise multivariate regression analyses.
Conclusions: Increased PCWP and decreased SVI independently contribute to elevated intact PTH in patients with CHF.