Introduction
Primary hyperparathyroidism (PHPT) is an endocrine disease characterized
by excessive release of parathyroid hormone (PTH), resulting in
dysregulation of calcium (Ca) metabolism (1 ). Although clinical
practice focuses more on adverse effects such as renal complications and
osteoporosis in hyperparathyroidism, PHPT has been shown to be
associated with increased cardiovascular morbidity and mortality
(2 ).
Atrial fibrillation (AF) is an important heart rhythm disorder common in
clinical practice, which causes hemodynamic disorders, frequent
hospitalizations, and thromboembolic events, and affects 1-2% of the
general population (3). Although the exact mechanisms causing
AF are not fully understood, hypertension, heart failure,
diastolic dysfunction, endothelial
dysfunction and left ventricular hypertrophy play an important role in
the pathogenesis of AF (3, 4 ). Side effects such as
hypertension, diastolic dysfunction, endothelial dysfunction, left
ventricular hypertrophy can also be seen in PHPT disease (2) .
Therefore, these patients may be at increased risk of newly developing
AF.
The atrial conduction time (ACT) represents the interval between sinus
impulses and atrial mechanical contraction. As an alternative to
invasive electrophysiological measurements, it may be measured
noninvasively by Tissue Doppler Imaging (TDI) (5 ). The
prolongation of intra- and inter-atrial conduction time, called atrial
electromechanical delay (EMD), is associated with the frequency and
sensitivity of atrial fibrillation (6).
To the best of our knowledge, atrial conduction abnormalities have not
been previously evaluated in patients with PHPT. Therefore, we aimed to
evaluate the atrial conduction time in PHPT patients with TDI, which is
a noninvasive method. In addition, we wanted to investigate whether
there is a relationship between atrial conduction time and parathyroid
hormone and serum calcium levels.