Abstract 2346: Femoral Neck T-score is Associated with Myocardial Ischemia and Decreased Exercise Duration by Exercise Echocardiography
BACKGROUND Low bone mineral density (BMD) has been associated with atherosclerosis and cardiovascular mortality. No studies have determined the relationship between BMD and results of stress echocardiography; a commonly used clinical measure of coronary disease and cardiac function.
METHODS Patients with a baseline bone densitometry study followed by an exercise echocardiogram from 1998 –2003 were included. Main outcome measures were exercise duration and ischemia on exercise echocardiography, defined as new or worsening regional wall motion.
RESULTS Overall, 54,022 patients with BMD measurements were identified; 1,143 with exercise echocardiography were included. Six-hundred-seventy-three (59%) had a T-score ≤ −1.0 (66±10 years, 86% female) and 470(41%) had a T-score >-1.0 (60±10 years; 88% female). Ischemia on exercise echo was seen in 142(21%) patients with low BMD and 70(14%) in those with normal BMD (p=0.007). For every 1 standard deviation decrease in femoral neck T-score, there was a 0.23 minute decrease in exercise duration on exercise treadmill studies after adjustments including age, sex, diabetes, hypertension, smoking, body mass index, prior myocardial infarction and estrogen use (95% CI=0.11– 0.35; p=0.0002). Furthermore, for every 1 standard deviation decrease in T-score there was a 22% increased risk of myocardial ischemia after adjustments and allowing for differences in exercise duration (HR=1.22, 95% CI=1.05–1.40; p=0.008)(Figure⇓).
CONCLUSIONS Lower T-score is associated with decreased exercise duration and increased risk of myocardial ischemia on exercise echocardiography. Further studies are indicated to explore this relationship.