Effect of Parathyroidectomy Upon Left Ventricular Mass in XXXX : A Meta-Analysis.

@entity1 @entity459 @entity4045 @entity460 @entity461 @entity1002
CONTEXT: @entity459 ( @entity459 ) has been associated with increased @entity1002 ( @entity1002 ) in many studies. Most studies have been inadequately powered to assess the effect of parathyroidectomy ( @entity4045 ) on @entity1002 . OBJECTIVE: The objective was to evaluate whether @entity4045 has a benefit on @entity1002 in @entity1 with @entity459 . DATA SOURCES: Sources included PubMed, Medline, Cochrane Library, clinicaltrials.gov , review articles, and abstracts from meetings. STUDY SELECTION: Eligible studies included prospective studies of @entity4045 vs observation or @entity4045 alone in @entity1 with @entity459 who had @entity1002 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 @entity1 undergoing @entity4045 were included. @entity4045 was associated with a reduction in @entity1002 (crude Hedges gu -0.290    0.070, 95% confidence interval [CI] -0.423 to -0.157) of 11.6 g/m(2) (12.5%) on average. Effect size estimates differed by study duration (P < .001), with improvements seen in shorter ( <=6 mo) but not longer studies. There was a trend toward greater improvement in observational studies vs randomized controlled trials (P = .07), and both serum @entity460 and @entity461 were higher in the former. Using random-effects models, the estimated effect size remained significant (Hedges gu -0.250, 95% CI -0.450 to -0.050). Higher preoperative @entity461 but not @entity460 was associated with a greater decline in @entity1002 (b = -.039, 95% CI -0.075 to -0.004). CONCLUSION: @entity4045 reduced @entity1002 in @entity459 , and higher preoperative @entity461 levels were associated with greater improvements. Because the benefit was limited to short-term studies and @entity459 disease severity was not independent of study design, further work is needed to clarify the factors that influence the change in @entity1002 and whether the benefit persists beyond 6 months after @entity4045 . Although the clinical significance of the @entity1002 improvement is unclear, these data indicate that @entity461 may underlie increased @entity1002 in @entity459 .
