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Parathyroid hormone in coronary artery disease — Results of a prospective study —

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Abstract

Parathyroid hormone (PTH) influences the calcium metabolism of many different mammalian cell types; indeed, hypertension due to changes in muscle tone is a frequent symptom of hypercalcemic hyperparathyroidism. In a blind study of 81 patients with various forms of heart disease undergoing coronary angiography, the plasma concentrations of the midcarboxyl regional PTH immunoreactivity were determined. PTH concentrations were elevated in 26 of the 56 patients exhibiting organic coronary artery disease (CAD). The plasma PTH levels were highest in those patients with CAD affecting three vessels and in patients with evidence of myocardial infarction. PTH levels were not influenced by previous drug treatments, and did not correlate to stress hormone levels. We propose that increased PTH levels may be a marker for initiation or potentiation of calcium-dependent changes in vascular smooth muscle behavior inducing coronary functional and anatomic lesions typical of CAD.

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References

  1. Oliva P.V., Pitts D.E., Piuss R.G. Coronary arterial spasm in Prinzmetal angina: documentation by coronary arteriography. N. Engl. J. Med. 288: 745, 1973.

    Article  PubMed  CAS  Google Scholar 

  2. Maseri A., L’Abbate A., Baroldi G., Chiercha S., Marzilli M., Balletra A.M., Severi S., Paroli O., Biagini A., Distante A., Pesta A. Coronary vasospasm as a possible cause of myocardial infarction: a conclusion derived from the study of “preinfarction” angina. N. Engl. J. Med. 299: 1271, 1978.

    Article  PubMed  CAS  Google Scholar 

  3. Rafflenbau W., Lichtlen P.R. Zum Konzept der “dynamischen” Koronarstenose. Z. Kardiol. 71: 439, 1982.

    Google Scholar 

  4. Grün G., Weder U., Fleckenstein A. The mutual antagonism between H+ and Ca++ ions in the control of vascular tone and autoregulation. Pflügers Arch. Ges. Physiol. 335 (Suppl.): R 10, 1972.

    Article  Google Scholar 

  5. Blaustein M.P. Sodium ions, calcium ions, blood pressure regulation and hypertension: a reassessment and a hypothesis. Am. J. Physiol. 177: C165, 1977.

    Google Scholar 

  6. Moore W.T., Smith L.D. Experience with a calcium infusion test in parathyroid disease. Metabolism 12: 447, 1983.

    Google Scholar 

  7. Borle A.B. Calcium metabolism in Hela cells and the effect of parathyroid hormone. J. Cell Biol. 36: 567, 1968.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  8. Chausmer A.B., Shermann B.S., Wallach S. The effect of parathyroid hormone on hepatic cell transport of calcium. Endocrinology 90: 663, 1972.

    Article  PubMed  CAS  Google Scholar 

  9. Whitfield J.F., MacManus J.P., Youdale T., Franks D.J. The roles of calcium and cyclic AMP in the stimulatory action of parathyroid hormone on thymic lymphocyte proliferation. J. Cell. Physiol. 78: 355, 1971.

    Article  PubMed  CAS  Google Scholar 

  10. Fleckenstein A. Calcium antagonism in heart and smooth muscle. J. Wiley and Sons, New York, Chichester, Brisbane, Toronto, Singapore, 1983.

    Google Scholar 

  11. Fleckenstein A., Frey M., von Witzleben H. Vascular calcium overload -a pathogenic factor in arteriosclerotisis and its neutralization by calcium antagonists. In: Kaltenbach M., Neufeld H.N. (Eds.), 5th International Adalat Symposium. Excerpta Medica, Amsterdam, Oxford, Princeton, 1983, p. 36.

    Google Scholar 

  12. Roberts W.C., Waller B.F. Effect of chronic hypercalcemia on the heart. Am. J. Med. 71: 371, 1981.

    Article  PubMed  CAS  Google Scholar 

  13. Selye H. The pluricausal cardiopathies. Charles C. Thomas Publisher, Springfield, Ill., 1961.

    Google Scholar 

  14. Lehr D. The role of certain electrolytes and hormones in disseminated myocardial necrosis. In: Bajusz E. (Ed.), Elektrolyte and cardiovascular disease. S. Karger, Basel, 1966, p. 248.

    Google Scholar 

  15. Kramsch D.M., Aspen A.J., Apstein C.S. Suppression of experimental atherosclerosis by the Ca++-antagonist lanthanum. J. Clin. Invest. 65: 967, 1980.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  16. Kleerehoper M., Dhanwada M.B., Rao S., Frame B. Hypercalcemia, hyperparathyroidism and hypertension. Cardiovasc. Med. 3: 1283, 1978.

    Google Scholar 

  17. Yasue H., Tonyama M., Kato H., Tanaka S., Akiyama F. Prinzmetal’s variant from of angina as a manifestation of alpha-adrenergic receptor — mediated coronary artery spasm: documentation by coronary arteriography. Am. Heart J. 91: 148, 1976.

    Article  PubMed  CAS  Google Scholar 

  18. Lamo S., Lhoste F., Anclair M.C., Lechat P. Interaction between parathyroid hormone and the beta-adrenoceptor system in cultured rat myocardial cells. J. Mol. Cell. Cardiol. 12: 955, 1980.

    Article  Google Scholar 

  19. Bogin E., Massry S.G., Harary I. Effect of parathyroid hormone on rat heart cells. J. Clin. Invest. 67: 1215, 1981.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  20. Schleiffer R., Berthelot A., Gaillard A. Effects of parathyroid extract on blood pressure and arterial contraction and on 45 Ca exchange in isolated aorta in the rat. Blood Vessels 16: 220, 1979.

    Google Scholar 

  21. Bernstein D.S., Pletka P., Hattner R.S., Hampers C.L., Merrill J.P. Effect of total parathyroidectomy and uremia on the chemical composition of bone, skin, and aorta in the rat. Isr. J. Med. Sci. 7: 513, 1971.

    PubMed  CAS  Google Scholar 

  22. Walter G.L., Williamson P.M., Ravich R.M.B., Rode J. Hypercalcemia associated with cerebral vasospasm causing infarction. J. Neurol. Neurosurg. Psychiatry 43: 464, 1980.

    Article  Google Scholar 

  23. Atkinson M.J., Niepel B., Jùppner H., Buth R., Casaretto M., Zahn H., Hehrmann R., Hesch R.D. Homologous radioimmunoassay for human mid-regional parathyroid hormone. J. Endocrinol. Invest. 4: 363, 1981.

    Article  PubMed  CAS  Google Scholar 

  24. Scholz H.C., Nordmeyer J.P., Jùppner H., Liebau H., Hesch R.D. PTH-action on vasoactive and diuretic hormones. Acta Endocrinol. (Kbh.) (Suppl. 234) 94: 124, 1980.

    Google Scholar 

  25. Köbberling J.A., von zur Mühlen A. Metodische Untersuchungen zur Bestimmung der Plasmacorticoide mit der Protein-Bindungsmethode. Z. Klin. Chem. 10: 67, 1972.

    Google Scholar 

  26. Hesch R.D., Bodenstein H., Atkinson M.J. Peptide hormone factors from lymphocytes. In: Hesch R.D., and Atkinson M.J. (Eds.), Peptide Hormones as Mediators in Immunology and Oncology. Serono Symposium, New York, Raven Press, 1985.

    Google Scholar 

  27. Stanton R.C., Plant S.B., McCarron D.A. CAMP response of vascular smooth muscle cells to bovine parathyroid hormone. Am. J. Physiol. 247: E822, 1985.

    Google Scholar 

  28. Lowik C.W.G.M., Vanleeuwen J.P.T.M., Vandermeer J.M., Vanzeeland J.K., Scheven B.A.A., Herrmann-Eulee M.P.M. A 2-receptor model for the action of parathyroid-hormone on osteoblasts — a role for intracellular free calcium and camp. Cell Calcium 6: 311, 1985.

    Article  PubMed  CAS  Google Scholar 

  29. Bohr D.F. Vascular smooth muscle updated. Circuí. Res. 32: 655, 1973.

    Google Scholar 

  30. Fabiato A., Fabiato F. Calcium and cardiac excition-contraction coupling. Ann. Rev. Physiol. 41: 473, 1979.

    Article  CAS  Google Scholar 

  31. Bidot-Lopez P., Farese R.V., Sabir M.A. Parathyroid hormone and adenosine -3′, 5, -monophosphate actuely increase phospholipids of the phosphatidate-polyphosphoinositide pathway in rabbit kidney cortex tubules in vitro by a cycloheximide sensitive process. Endocrinology 108: 2078, 1981.

    Article  PubMed  CAS  Google Scholar 

  32. Hesch R.D., Herrmann G., Parris A.D., Atkinson M.J. The type II PTH-receptor operated calcium channel and its importance for PTH-peptide elevations in coronary artery disease. Am. J. Nephrol, (in press).

  33. MacGregor G.A., de Wardener H.E. Is a circulating sodium transport inhibitor involved in the pathogenesis of essential hypertension? Clin. Exp. Hypertens. 3: 815, 1981.

    Article  PubMed  CAS  Google Scholar 

  34. Garay R.P., Dagher G., Pernollet M.G., Devynde M.A., Meyer P. Inherited defect in a Na+-cotransport system in erythrocytes from essential hypertensive patients. Nature 284: 281, 1980.

    Article  PubMed  CAS  Google Scholar 

  35. Orlov S.N., Postnov Y.V. Ca++-binding and membrane fluidity in essential and renal hypertension. Clin. Sci. Mol. Med. 63: 281, 1982.

    CAS  Google Scholar 

  36. Christensson T., Hellström K., Wengler B. Blood pressure in subjects with hypercalcemia and primary hyperparathyroidism detected in a health screening program. Eur. J. Clin. Invest. 7: 109, 1977.

    Article  PubMed  CAS  Google Scholar 

  37. Blum M., Kirsten M., Worth M.H. Reversible hypertension caused by the hypercalcemia of hyperparathyroidism, vitamin D toxicity and calcium infusion. JAMA 237: 262, 1977.

    Article  PubMed  CAS  Google Scholar 

  38. Resnick L.M., Laragh J.N., Sealey J.E., Alerman M.H. Divalent cations in essential hypertension. Relations between serum ionized calcium, magnesium, and plasma renin activity. N. Engl. J. Med. 309: 888, 1983.

    Article  PubMed  CAS  Google Scholar 

  39. Glogar D., Zilcher H., Lintner F., Kern H.G., Willvonseder R. Calcium-induzierte Nekrose des Herzmuskels als Todesursache bei akutem Hyperparathyroidism. Dtsch. Med. Wochenschr. 105: 301, 1980.

    Google Scholar 

  40. Schettler T., Aufmkolk B., Atkinson M.J., Radeke H., Enters C., Hesch R.D. Analysis of immunoreactive and biologically active human parathyroid hormone-peptides by high-performance-liquid-chromatography. Acta Endocrinol. (Kbh.) 107: 60, 1984.

    CAS  Google Scholar 

  41. Niepel B., Radeke H., Atkinson M.J., Jüppner H., Hesch R.D. A homologous biological probe for parathyroid hormone in human serum. J. Immunoassay 4: 21, 1983.

    Article  PubMed  CAS  Google Scholar 

  42. Law W.M., Heath III H. Time- and dose related biphasic effects of synthetic bovine parathyroid hormone fragment 1–34 on urinary cation excretion. J. Clin. Endocrinol. Metab. 58: 606, 1984.

    Article  PubMed  CAS  Google Scholar 

  43. Harney A.N., Kuhreja S.C., Hargis G.K., Johnson P.A., Bowser N.E., Williams G.A. Effect of long-term administration of epinephrine and propranolol on serum calcium, parathyroid hormone and calcitonin in the rat. Proc. Soc. Exp. Biol. Med. 159: 266, 1978.

    Article  PubMed  CAS  Google Scholar 

  44. Fischer J.A., Blum J.W., Binswanger U. Acute parathyroid hormone response to epinephrine in vivo. J. Clin. Invest. 52: 2434, 1973.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  45. Kukreja S.C., Ayala G.A., Banarjee P., Bowser E.N., Hargis E.K., Williams G.A. Characterization of beta-adrenergic receptor mediated secretion of parathyroid hormone. Horm. Metab. Res. 12: 334, 1980.

    Article  PubMed  CAS  Google Scholar 

  46. Rosenblatt M. Control of parathyroid hormone secretion. Contrib. Nephrol. 33: 163, 1982.

    PubMed  CAS  Google Scholar 

  47. McCarron D.A., Pringree P.A., Molitch M., Krutzik S., Rubin R.J. Parathyroid hormone and mineral homeostasis during propranolol therapy for essential hypertension, Mineral. Electrol. Metab. 5: 8, 1981.

    Google Scholar 

  48. Vollmer F., Güthert H. Zum Problem der Kronarspasmen. Dtsch. Med. Wochenschr. 107: 764, 1982.

    Google Scholar 

  49. Conti C.R. Coronary-artery spasm and myocardial infarction. N. Engl. J. Med. 309: 238, 1983.

    Article  PubMed  CAS  Google Scholar 

  50. Moise A., Theroux P., Taeymans Y., Descoings B., Lesperance J., Waters D., Pelletier G.B., Bourassa M.G. Unstable angina and progression of coronary atherosclerosis. N. Engl. J. Med. 309: 685, 1983.

    Article  PubMed  CAS  Google Scholar 

  51. Maseri A., Chierchia S., L’Abbate A. Pathogenetic mechanism underlying the clinical events associated with atherosclerotic heart disease. Circulation 62(Suppl. 5): V–3, 1980.

    Google Scholar 

  52. Robertson D., Oates J.A. Variant angina and Raynaud’s phenomenon. Lancet 1: 452, 1978.

    Article  PubMed  CAS  Google Scholar 

  53. Osler W. The principles and practice of medicine, ed. 1. Appieton, New York, 1982.

    Google Scholar 

  54. Dagenais G.R., Gundel W.D., Conti C.R. Peripheral venospasm associated with signs of transient myocardial ischemia. Am. Heart J. 80: 544, 1979.

    Article  Google Scholar 

  55. Endo M., Hirosawa K., Kaneko N., Hase K., Inoue Y., Vonno S. Prinzmetal’s variant angina: coronary arteriogram and left ventriculugram during angina attack induced by methacholine. N. Engl. J. Med. 294: 252, 1976.

    Article  PubMed  CAS  Google Scholar 

  56. Kuzuay T., Tada M., Inoue M., Kodama K., Takeda H., Inui M., Abe H. Increased levels of thromoxane A-2 in peripheral and coronary circulation in patients with angina pectoris. Am. J. Cardiol. 45: 454, 1980 (abstract).

    Article  Google Scholar 

  57. Robertson R.M., Robertson D., Roberts L.J., Mass R.L., Fitzgerald G.A., Friesinger G.C., Oates J.A. Thromboxane A-2 in vasotonic angina pectoris. Evidence from direct measurements and inhibitor trials. N. Engl. J. Med. 304: 998, 1981.

    Article  PubMed  CAS  Google Scholar 

  58. Crass M.F. III, Pang P.K.T. Parathyroid hormone: A coronary artery vasodilator. Science 207: 1087, 1980.

    Article  PubMed  CAS  Google Scholar 

  59. Pang P.K.T., Yang M.C.M., Tenner T.E., Chang J.K., Shimizu M. Hypotensive action of synthetic fragments of parathyroid hormone. J. Pharmacol. Exp. Ther. 216: 567, 1981.

    PubMed  CAS  Google Scholar 

  60. Mandrup-Poulsen T., Owerbach D., Mortensen S.A., Johansen K., Meinertz H., Sorensen H., Nerup J. DNA sequences flanking the insulin gene on chromosome 11 confer risk of atherosclerosis. Lancet 1: 250, 1984.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Departments of Endocrinology, Medizinische Hochschule, D-3000, Hannover 61, FRG

    G. Herrmann & P. Lichtlen

  2. Medizinische Hochschule, D-3000, Hannover 61, FRG

    R. Hehrmann, H. C. Scholz, M. Atkinson, A. von zur Mühlen &  R. D. Hesch

  3. Abteilung Klinische Endokrinologie, Zentrum Innere Medizin und Dermatologie, Medizin. Hochschule Hannover, Konstanty-Gutschow-Str. 8, D-3000, Hannover 61, FRG

    R. D. Hesch

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  1. G. Herrmann
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  3. H. C. Scholz
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Supported by a grant of the Deutsche Forschungsgesellschaft He 593/13.

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Herrmann, G., Hehrmann, R., Scholz, H.C. et al. Parathyroid hormone in coronary artery disease — Results of a prospective study —. J Endocrinol Invest 9, 265–271 (1986). https://doi.org/10.1007/BF03346923

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