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2009 Southern Regional Meeting Abstracts
Session: Joint Plenary Poster Session and Reception
SECONDARY HYPERPARATHYROIDISM AND HYPOVITAMINOSIS D IN AFRICAN-AMERICAN PATIENTS HOSPITALIZED WITH DECOMPENSATED BIVENTRICULAR FAILURE. REPRODUCIBILITY AND SUMMER VERSUS WINTER MONTHS
Whitted AD, Ali S, Shahbaz AU, Zafarullah H, Newman KP, Davis RC, Weber KT. University of Tennessee Health Science Center, Memphis, TN.
Purpose of Study: Nine consecutive African-American (AA) patients, without renal failure, who were hospitalized at the Regional Medical Center (MED) in Memphis (latitude 35°N) with decompensated biventricular failure (DecompHF), in February, 2005, were found to have secondary hyperparathyroidism (SHPT) with elevated plasma parathyroid hormone (PTH; >65 pg/mL); this included 5 patients who were newly diagnosed and not receiving medical treatment (Am J Med Sci 2006;331:30-4). During August, 2005, 20 AA hospitalized with DecompHF were found to have ionized hypocalcemia with SHPT and vitamin D deficiency (serum 25(OH)D <30 ng/dL) (Am J Med Sci 2006;332:112-8). The reproducibility of these findings and the role of summer vs. winter months in their appearance was not considered in these earlier reports.
Methods Used: Accordingly, we retrospectively compared AA patients with EF <30% due to a dilated cardiomyopathy of ischemic or nonischemic origin, who were consecutively admitted to the Cardiology Service at the MED with DecompHF: a) 13 (10 M; 58.9±1.7 yrs) and 13 (10 M; 53.2±3.5 yrs) patients hospitalized during either February, 2007 or February, 2008, respectively; and b) the 13 patients seen in February, 2008 and 12 others (10 M; 34.8±5.3 yrs) seen during August, 2008. The clinical presentation of DecompHF included: jugular venous distention; tricuspid regurgitation; and bilateral lower extremity edema; while echocardiographic evidence included a dilated inferior vena cava without respiratory variation. Serum creatinine in all patients was <2.0 mg/dL).
Summary of Results: (mean±SEM)
Conclusions: Thus in AA hospitalized here in Memphis, our retrospective study confirms SHPT and hypovitaminosis D to be covariants of DecompHF irrespective of the time of year. Plasma PTH and serum 25(OH)D should be routinely monitored in AA with DecompHF and appropriate corrective measures taken.
| Feb 2007 | Feb 2008 | Aug 2008 | | PTH (pg/mL) | 112.4±22.5 | 154±33.2 | 116.8±19.3 | | 25(OH)D (ng/dL) | 10.4±1.7 | 10.7±1.4 | 15.8±2.1 |
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