Effect of parathyroidectomy upon left ventricular mass in primary hyperparathyroidism: A meta-analysis

Abstract

Context: Primary hyperparathyroidism (PHPT) has been associated with increased left ventricular mass (LVM) in many studies. Most studies have been inadequately powered to assess the effect of parathyroidectomy (PTX) on LVM. Objective: The objective was to evaluate whether PTX has a benefit on LVM in patients with PHPT. Data Sources: Sources included PubMed, Medline, Cochrane Library, clinicaltrials.gov, review articles, and abstracts from meetings. Study Selection: Eligible studies included prospective studies of PTX vs observation or PTX alone in patients with PHPT who had LVM measured by echocardiography. Data Extraction: Two investigators independently identified eligible studies and extracted data. Random-effects models were used to obtain final pooled estimates. Data Synthesis: Fifteen studies (four randomized controlled trials and 11 observational) of 457 participants undergoing PTX were included. PTX was associated with a reduction in LVM (crude Hedges gu -0.± 0.070, 95% confidence interval [CI] -0.423 to -0.157) of 11.6 g/m2 (12.5%) on average. Effect size estimates differed by study duration (P