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2019, Número 2

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Cir Cir 2019; 87 (2)


Evaluación de la función endotelial y la función diastólica en pacientes con hiperparatiroidismo primario antes y después de la paratiroidectomía

Magriñá-Mercado RM, Ramírez-Rentería C, Almeida-Gutiérrez E, Mendoza-Zubieta V, Ferreira-Hermosillo A

Idioma: Español
Referencias bibliográficas: 30
Paginas: 196-204
Archivo PDF: 395.34 Kb.


RESUMEN

Introducción: El hiperparatiroidismo primario (HPTP) es la principal causa de hipercalcemia ambulatoria y se ha asociado con un riesgo cardiovascular elevado. La vasodilatación mediada por flujo (VMF) es un método no invasivo que evalúa la función endotelial. Objetivo: Comparar la disfunción endotelial mediante VMF y la disfunción diastólica en pacientes con HPTP antes y después de la paratiroidectomía. Método: Mediante un estudio cuasiexperimental (antes-después) se evaluaron la función diastólica y la VMF antes y 6 meses después de realizar una paratiroidectomía. Resultados: Se incluyeron 15 pacientes con HPTP: 12 mujeres (80%) y 3 hombres (20%); el 73% presentaron litiasis, el 27% osteoporosis y el 53% síndrome metabólico; el 73% tenían disfunción diastólica antes de la cirugía y el 60% después de la cirugía (p = 0.09). Los diámetros braquiales post-isquemia mejoraron de 41 mm antes de la cirugía a 46 mm tras la cirugía (p = 0.020). Así mismo, los diámetros braquiales preisquemia vs. post-isquemia después de la cirugía mejoraron de 41 a 46 mm (p = 0.005). Antes de la cirugía, el cambio en la delta del diámetro braquial preisquemia y post-isquemia fue de 1 mm, y subió a 4 mm después de la cirugía (p = 0.03). Conclusiones: Existe una menor disfunción endotelial medida por VMF en pacientes posoperados por HPTP a los 6 meses de la cirugía. El estudio ecocardiográfico puede ser de utilidad en la evaluación preoperatoria de los pacientes con HPTP asintomáticos.


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