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Article

Plasma Levels of Intact Parathyroid Hormone and Congestion Burden in Heart Failure: Clinical Correlations and Prognostic Role

by
Pietro Scicchitano
1,
Massimo Iacoviello
2,
Andrea Passantino
3,
Michele Gesualdo
1,
Francesco Trotta
1,
Marco Basile
1,
Micaela De Palo
4,
Piero Guida
5,
Claudio Paolillo
6,
Graziano Riccioni
7,
Marco Matteo Ciccone
8,
Pasquale Caldarola
9 and
Francesco Massari
1,*
1
Cardiology Section, Hospital “F. Perinei”, 70022 Altamura, BA, Italy
2
Cardiology Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, FG, Italy
3
Division of Cardiology and Cardiac Rehabilitation, Scientific Clinical Institutes Maugeri, IRCCS Institute of Bari, 70124 Bari, BA, Italy
4
Cardiac Surgery Unit, Policlinic University Hospital, Piazza Giulio Cesare 11, 70124 Bari, BA, Italy
5
Ospedale Generale Regionale “F. Miulli”, 70021 Acquaviva delle Fonti, BA, Italy
6
Cardiology Section, Hospital “Umberto I”, 70033 Corato, BA, Italy
7
Cardiology Unit, San Camillo de Lellis, Hospital, Via Isonzo 1, 71043 Manfredonia, FG, Italy
8
Cardiology Unit, Policlinic University Hospital, Piazza Giulio Cesare 11, 70124 Bari, BA, Italy
9
Cardiology Section, Hospital “S. Paolo”, 70123 Bari, BA, Italy
*
Author to whom correspondence should be addressed.
J. Cardiovasc. Dev. Dis. 2022, 9(10), 334; https://doi.org/10.3390/jcdd9100334
Submission received: 19 August 2022 / Revised: 28 September 2022 / Accepted: 30 September 2022 / Published: 2 October 2022
(This article belongs to the Section Electrophysiology and Cardiovascular Physiology)
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Abstract

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.
Keywords: heart failure; BIVA; BNP; PTH; prognosis; HYDRA score; congestion heart failure; BIVA; BNP; PTH; prognosis; HYDRA score; congestion
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MDPI and ACS Style

Scicchitano, P.; Iacoviello, M.; Passantino, A.; Gesualdo, M.; Trotta, F.; Basile, M.; De Palo, M.; Guida, P.; Paolillo, C.; Riccioni, G.; et al. Plasma Levels of Intact Parathyroid Hormone and Congestion Burden in Heart Failure: Clinical Correlations and Prognostic Role. J. Cardiovasc. Dev. Dis. 2022, 9, 334. https://doi.org/10.3390/jcdd9100334

AMA Style

Scicchitano P, Iacoviello M, Passantino A, Gesualdo M, Trotta F, Basile M, De Palo M, Guida P, Paolillo C, Riccioni G, et al. Plasma Levels of Intact Parathyroid Hormone and Congestion Burden in Heart Failure: Clinical Correlations and Prognostic Role. Journal of Cardiovascular Development and Disease. 2022; 9(10):334. https://doi.org/10.3390/jcdd9100334

Chicago/Turabian Style

Scicchitano, Pietro, Massimo Iacoviello, Andrea Passantino, Michele Gesualdo, Francesco Trotta, Marco Basile, Micaela De Palo, Piero Guida, Claudio Paolillo, Graziano Riccioni, and et al. 2022. "Plasma Levels of Intact Parathyroid Hormone and Congestion Burden in Heart Failure: Clinical Correlations and Prognostic Role" Journal of Cardiovascular Development and Disease 9, no. 10: 334. https://doi.org/10.3390/jcdd9100334

APA Style

Scicchitano, P., Iacoviello, M., Passantino, A., Gesualdo, M., Trotta, F., Basile, M., De Palo, M., Guida, P., Paolillo, C., Riccioni, G., Ciccone, M. M., Caldarola, P., & Massari, F. (2022). Plasma Levels of Intact Parathyroid Hormone and Congestion Burden in Heart Failure: Clinical Correlations and Prognostic Role. Journal of Cardiovascular Development and Disease, 9(10), 334. https://doi.org/10.3390/jcdd9100334

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