670 | wileyonlinelibrary.com/journal/echo Echocardiography. 2020;37:670–677. © 2020 Wiley Periodicals, Inc. Received: 6 January 2020 | Revised: 15 February 2020 | Accepted: 23 March 2020 DOI: 10.1111/echo.14660 The effect of successful parathyroid surgery on left ventricle function in patients with primary hyperparathyroidism evaluated with strain echocardiography Ahmet Atasever MD 1 | Emre Özdemir MD 2 | Turan Acar MD 1 | Sadık Volkan Emren MD 2 | Selda Hacıyanlı MD 1 | Mehmet Hacıyanlı MD, FACS, FEBS(hon) 1 1 General Surgery Clinic, Ataturk Training and Research Hospital, Katip Celebi University, Izmir, Turkey 2 Cardiology Clinic, Ataturk Training and Research Hospital, Katip Celebi University, Izmir, Turkey Correspondence Emre Özdemir, MD, Cardiology Clinic, Ataturk Training and Research Hospital, Katip Celebi University, Basın Sitesi Mah, Hasan Tahsin Cad No: 143 PK:35150 Karabağlar, Izmir, Turkey. Email: emreozdemir27@yahoo.com.tr Abstract Background: Hyperparathyroidism (PHP) is the most common cause of hypercal- cemia in outpatients. It is characterized by many cardiac complications including chronic cardiac arrhythmia, hypertrophy, and diastolic insufficiency. However, there are insufficient data about the cardiac systolic function in PHP. Data regarding the positive effects of surgical treatment on cardiac complications are limited and inad- equate. The aim of this study was to evaluate the postoperative changes in the left ventricle functions of patients with PHP using strain echocardiography (STE) instead of traditional echocardiographic evaluation. Methods: This prospective study included 29 patients with PHP. Detailed echocar - diographic evaluations were made including conventional and STE‚ ventricle function preoperatively and at 6 months after surgery. Then, preoperative and postoperative STE changes, global longitudinal (GLS) and circumferential strain (GCS), were com- pared. Patients with recurrent surgery, poor echogenicity, and comorbid conditions affecting STE were excluded. Results: No significant change was determined in ejection fraction in the period from preoperative to 6 months postoperative (P > .05). The GLS value increased from 18.53 ± 3.06 to 20.25 ± 3.89, to a statistically significant level (P = .004). The other echocardiographic parameters remained unchanged for the same patients. Conclusion: Despite normal 2D echocardiography data, it was determined that the GLS values deteriorated preoperatively and improved by the 6th postoperative month. The de- tection of early disorders in PHP that cannot be detected on 2D echocardiography, even in asymptomatic patients, may suggest a new treatment indication. For asymptomatic PHP patients, strain echocardiography may be more valuable than 2D echocardiographic evaluation to determine myocardial dysfunction. The recent literature is insufficient, and there is a need for further, more extensive studies with longer follow-up periods. KEYWORDS hyperparathyroidism, myocardial dysfunction, parathyroidectomy, strain echocardiography