Plasma Levels of Intact Parathyroid Hormone and Congestion Burden in Heart Failure: Clinical Correlations and Prognostic Role
Circulating parathyroid hormone (PTH) concentrations increase in heart failure (HF) and are related to disease severity. The relationship between PTH and congestion is still a matter of debate. The objective of this analysis was to evaluate the role of PTH as a marker of congestion and prognosis in...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/9/10/334 |
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| author | Pietro Scicchitano Massimo Iacoviello Andrea Passantino Michele Gesualdo Francesco Trotta Marco Basile Micaela De Palo Piero Guida Claudio Paolillo Graziano Riccioni Marco Matteo Ciccone Pasquale Caldarola Francesco Massari |
| author_facet | Pietro Scicchitano Massimo Iacoviello Andrea Passantino Michele Gesualdo Francesco Trotta Marco Basile Micaela De Palo Piero Guida Claudio Paolillo Graziano Riccioni Marco Matteo Ciccone Pasquale Caldarola Francesco Massari |
| author_sort | Pietro Scicchitano |
| collection | DOAJ |
| description | Circulating parathyroid hormone (PTH) concentrations increase in heart failure (HF) and are related to disease severity. The relationship between PTH and congestion is still a matter of debate. The objective of this analysis was to evaluate the role of PTH as a marker of congestion and prognosis in HF. We enrolled 228 patients with HF. Intact PTH concentrations and HYDRA score (constituted by: B-type natriuretic peptide, blood urea nitrogen–creatinine ratio, estimated plasma volume status, and hydration status) were evaluated. The study endpoint was all-cause mortality. PTH levels were higher in acute compared with chronic HF and in patients with clinical signs of congestion (i.e., peripheral oedema and orthopnea). PTH concentrations significantly correlated with NYHA class and HYDRA score. At multivariate analysis of HYDRA score, estimated glomerular filtration rate (eGFR), and corrected serum calcium were independently determinants of PTH variability. Fifty patients (22%) died after a median follow-up of 408 days (interquartile range: 283–573). Using univariate Cox regression analysis, PTH concentrations were associated with mortality (hazard ratio [HR]: 1.003, optimal cut-off: >249 pg/mL—area under-the-curve = 0.64). Using multivariate Cox regression analysis, PTH was no longer associated with death, whereas HYDRA score, left ventricular ejection fraction, and eGFR acted as independent predictors for mortality (HR: 1.96, 0.97, and 0.98, respectively). Our study demonstrated that intact PTH was related to clinical and subclinical markers of congestion. However, intact PTH did not act as an independent determinant of all-cause death in HF patients. |
| first_indexed | 2024-03-09T03:36:45Z |
| format | Article |
| id | doaj.art-b372503663794fafa91c0e026486c822 |
| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-09T03:36:45Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-b372503663794fafa91c0e026486c8222023-12-03T14:48:06ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252022-10-0191033410.3390/jcdd9100334Plasma Levels of Intact Parathyroid Hormone and Congestion Burden in Heart Failure: Clinical Correlations and Prognostic RolePietro Scicchitano0Massimo Iacoviello1Andrea Passantino2Michele Gesualdo3Francesco Trotta4Marco Basile5Micaela De Palo6Piero Guida7Claudio Paolillo8Graziano Riccioni9Marco Matteo Ciccone10Pasquale Caldarola11Francesco Massari12Cardiology Section, Hospital “F. Perinei”, 70022 Altamura, BA, ItalyCardiology Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, FG, ItalyDivision of Cardiology and Cardiac Rehabilitation, Scientific Clinical Institutes Maugeri, IRCCS Institute of Bari, 70124 Bari, BA, ItalyCardiology Section, Hospital “F. Perinei”, 70022 Altamura, BA, ItalyCardiology Section, Hospital “F. Perinei”, 70022 Altamura, BA, ItalyCardiology Section, Hospital “F. Perinei”, 70022 Altamura, BA, ItalyCardiac Surgery Unit, Policlinic University Hospital, Piazza Giulio Cesare 11, 70124 Bari, BA, ItalyOspedale Generale Regionale “F. Miulli”, 70021 Acquaviva delle Fonti, BA, ItalyCardiology Section, Hospital “Umberto I”, 70033 Corato, BA, ItalyCardiology Unit, San Camillo de Lellis, Hospital, Via Isonzo 1, 71043 Manfredonia, FG, ItalyCardiology Unit, Policlinic University Hospital, Piazza Giulio Cesare 11, 70124 Bari, BA, ItalyCardiology Section, Hospital “S. Paolo”, 70123 Bari, BA, ItalyCardiology Section, Hospital “F. Perinei”, 70022 Altamura, BA, ItalyCirculating parathyroid hormone (PTH) concentrations increase in heart failure (HF) and are related to disease severity. The relationship between PTH and congestion is still a matter of debate. The objective of this analysis was to evaluate the role of PTH as a marker of congestion and prognosis in HF. We enrolled 228 patients with HF. Intact PTH concentrations and HYDRA score (constituted by: B-type natriuretic peptide, blood urea nitrogen–creatinine ratio, estimated plasma volume status, and hydration status) were evaluated. The study endpoint was all-cause mortality. PTH levels were higher in acute compared with chronic HF and in patients with clinical signs of congestion (i.e., peripheral oedema and orthopnea). PTH concentrations significantly correlated with NYHA class and HYDRA score. At multivariate analysis of HYDRA score, estimated glomerular filtration rate (eGFR), and corrected serum calcium were independently determinants of PTH variability. Fifty patients (22%) died after a median follow-up of 408 days (interquartile range: 283–573). Using univariate Cox regression analysis, PTH concentrations were associated with mortality (hazard ratio [HR]: 1.003, optimal cut-off: >249 pg/mL—area under-the-curve = 0.64). Using multivariate Cox regression analysis, PTH was no longer associated with death, whereas HYDRA score, left ventricular ejection fraction, and eGFR acted as independent predictors for mortality (HR: 1.96, 0.97, and 0.98, respectively). Our study demonstrated that intact PTH was related to clinical and subclinical markers of congestion. However, intact PTH did not act as an independent determinant of all-cause death in HF patients.https://www.mdpi.com/2308-3425/9/10/334heart failureBIVABNPPTHprognosisHYDRA score |
| spellingShingle | Pietro Scicchitano Massimo Iacoviello Andrea Passantino Michele Gesualdo Francesco Trotta Marco Basile Micaela De Palo Piero Guida Claudio Paolillo Graziano Riccioni Marco Matteo Ciccone Pasquale Caldarola Francesco Massari Plasma Levels of Intact Parathyroid Hormone and Congestion Burden in Heart Failure: Clinical Correlations and Prognostic Role Journal of Cardiovascular Development and Disease heart failure BIVA BNP PTH prognosis HYDRA score |
| title | Plasma Levels of Intact Parathyroid Hormone and Congestion Burden in Heart Failure: Clinical Correlations and Prognostic Role |
| title_full | Plasma Levels of Intact Parathyroid Hormone and Congestion Burden in Heart Failure: Clinical Correlations and Prognostic Role |
| title_fullStr | Plasma Levels of Intact Parathyroid Hormone and Congestion Burden in Heart Failure: Clinical Correlations and Prognostic Role |
| title_full_unstemmed | Plasma Levels of Intact Parathyroid Hormone and Congestion Burden in Heart Failure: Clinical Correlations and Prognostic Role |
| title_short | Plasma Levels of Intact Parathyroid Hormone and Congestion Burden in Heart Failure: Clinical Correlations and Prognostic Role |
| title_sort | plasma levels of intact parathyroid hormone and congestion burden in heart failure clinical correlations and prognostic role |
| topic | heart failure BIVA BNP PTH prognosis HYDRA score |
| url | https://www.mdpi.com/2308-3425/9/10/334 |
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