Restored Cardiac Conditions and Left Ventricular Function After Parathyroidectomy in a Hemodialysis Patient: Parathyroidectomy Improves Cardiac Fatty Acid Metabolism Assessed by 123I-BMIPP

A 62 year-old female hemodialysis patient underwent parathyroidectomy to treat secondary hyperparathyroidism. On the preoperative assessment, the plasma levels of parathyroid hormone (PTH) and B-type natriuretic peptide (BNP) were elevated. Echocardiography showed reduced left ventricular (LV) contr...

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Bibliographic Details
Published in:Circulation Journal 2009, Vol.73(10), pp.1956-1960
Main Authors: Nanasato, Mamoru, Goto, Norihiko, Isobe, Satoshi, Unno, Kazumasa, Hirayama, Haruo, Sato, Tetsuhiko, Matsuoka, Susumu, Nagasaka, Takaharu, Tominaga, Yoshihiro, Uchida, Kazuharu, Murohara, Toyoaki
Format: Article
Language:English
Subjects:
Biomarkers - blood
Echocardiography
Fatty Acids - metabolism
Female
Hemodialysis
Humans
Hyperparathyroidism, Secondary - etiology
Hyperparathyroidism, Secondary - metabolism
Hyperparathyroidism, Secondary - surgery
Iodine Radioisotopes
Iodobenzenes
Kidney Failure, Chronic - complications
Kidney Failure, Chronic - metabolism
Kidney Failure, Chronic - therapy
Left ventricular function
Middle Aged
Myocardial Contraction
Myocardium - metabolism
Natriuretic Peptide, Brain - blood
Parathyroid Hormone - blood
Parathyroidectomy
Radiopharmaceuticals
Recovery of Function
Renal Dialysis
Scintigraphy
Stroke Volume
Tomography, Emission-Computed, Single-Photon
Treatment Outcome
Ventricular Dysfunction, Left - diagnostic imaging
Ventricular Dysfunction, Left - etiology
Ventricular Dysfunction, Left - metabolism
Ventricular Dysfunction, Left - physiopathology
Ventricular Function, Left
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Summary:A 62 year-old female hemodialysis patient underwent parathyroidectomy to treat secondary hyperparathyroidism. On the preoperative assessment, the plasma levels of parathyroid hormone (PTH) and B-type natriuretic peptide (BNP) were elevated. Echocardiography showed reduced left ventricular (LV) contraction. Myocardial iodine-123-15-(p-iodophenyl)-3-(R,S) methylpentadecanoic acid (123I-BMIPP) scintigraphy showed moderately reduced tracer uptake in the postero-inferior area on single-photon emission computed tomography and decreased washout on the planar images. After parathyroidectomy, the plasma levels of PTH and BNP decreased, followed by improvement in LV contraction. Myocardial 123I-BMIPP scintigraphy revealed that the washout on planar images had increased, which suggests that myocardial 123I-BMIPP scintigraphy is useful for estimating the effect of parathyroidectomy on cardiac function. (Circ J 2009; 73: 1956-1960)
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-08-0415