Evaluation of Tp-e interval, Tp-e/QT, and Tp-e/QTc ratio in primary hyperparathyroidism before and after parathyroidectomy

Abstract

Aims: This study aimed to evaluate Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratios, which are new ventricular repolarization (VR) parameters in primary hyperparathyroidism (PHPT) patients, and also investigate the potential effect of parathyroidectomy (PTx) on these parameters. Methods: In total, 27 patients with PHPT who underwent PTx and 25 control subjects were selected for our study. Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratios of patients planned for PTx were compared to healthy matched controls. Electrocardiographic parameters measured 6 months after the surgery were also compared with preoperative values for each patient. Results: Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio were significantly higher in PHPT patients compared to the control group (p<0.001, for all).It was observed that the parameters mentioned after surgery decreased significantly, and there was no statistical difference when compared to the control group.The correlation analysis revealed a significant and positive correlation between corrected calcium (CCa) and PTH levels with Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio (for Ca; r=0.515, p=0.006; r=0.398, p=0.040; r=0.797, p<0.001 respectively vs. for PTH; r=538, p=0.04; r=0.422, p=0.028; r=0.812, p<0.001 respectively). Conclusions: This study showed that Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were prolonged in PHPT.These values, which are accepted as an indicator of sudden cardiac death after PTx, decreased significantly. In addition, both high PTH and high calcium(Ca) levels appear to have the potential to cause arrhythmogenic effects separately.