| Objectives We aimed to investigate the role of serum parathyroid hormone levels(PTH) in the diagnostic value of heart failure in Chinese.Methods We randomly invited inpatients of Department of Cardiology in the Affiliated Hospital of Dali University to take part in our study from July, 2014 to July 2015. We enrolled inpatients with the following criteria: 1. Inpatients with the tested PTH; 2. Inpatients agreed to participate, exclusion criteria:inpatients with acute myocardial infarction or with acute heart failure. In 160 inpatients, 139 inpatients were included in the final analysis. Among them,inpatients with heart failure were 93 subjects, this was experiment group.Inpatients with normal heart function were 46 subjects, this was control group.We collected overnight fasting venous blood to test serum PTH, plasma BNP and other biochemical markers. Experienced technician performed echocardiographic examination for all inpatients within three days. SAS 9.3was used to manage and analyze the data.results One hundred and thirty nine participants included 93 heart failure patients(66.9%) and 46 inpatients(33.1%) without heart failure. Compared with patients with normal heart function, age, PTH, BNP, serum creatinine,coronary heart disease, heart failure patients were higher; systolic blood pressure, diastolic blood pressure, total cholesterol, HDL-C, normal heart function patients were higher(P <0.05). The serum PTH levels of 139 participants were not in normal distribution, thus log-transformed PTH levels were used for analyses. ln PTH was positive correlation with ln BNP(r = 0.33,P = 0.0008). After adjusted for sex, age, serum creatinine, serum calcium and phosphate, PTH levels of heart failure patients were significantly higher than those without heart failure(P <0.0001). Furthermore, serum PTH and plasma BNP levels were significantly increased with the severity of heart function assessed by NYHA methods both before and after adjusted for covariates(P≤0.0002). ROC analyses proved that serum PTH levels might be used to predict heart failure though its sensitivity was lower than BNP(AUC 0.6216 vs0.8038).After adjusted for sex, age, serum creatinine, calcium and phosphate,hypertension, coronary artery disease, and diabetes mellitus, log-transformed PTH was positively associated with left vertricular mass index(β = 42.3 g/m2,P = 0.04), left ventricular systolic diameter(β = 13.8 mm, P = 0.01), right ventricular diameter(β = 4.9 mm, P = 0.02), and negatively associated with left ventricular ejection fraction(β=-21.8%, P = 0.001). In addition, PTH was borderly related with left atrium diameter and left ventricular diastolic diameter.Conclusions Serum PTH elevated in patients with heart failure and was associated with the severity of heart failure. PTH might be involved in the pathogenesis of heart failure via aggravating left ventricular hypertrophy and impaired systolic function. However, the exact mechanisms are still unknown.Further studies are needed to elucidate the underlying mechanisms. |
