Abstract 15045: Exercise Capacity Independently Predicts Bone Mineral Density and Proximal Femoral Geometry in Patients With Acute Decompensated Heart Failure
Background: Heart failure is associated with increased risk of osteoporosis. However, the prevalence and predictors of osteoporosis in unselected patients with acute decompensated heart failure (ADHF) are not well investigated.
Methods: Sixty eight patients (60 ± 16 yrs, mean ejection fraction 29.3 ± 13.0%) with ADHF were prospectively and consecutively enrolled. Fifteen postmenopausal, three premenopausal women, and fifty male patients were analyzed. Quantitative CT scans for bone mineral density (BMD) as well as biochemical, echocardiographic and cardiopulmonary exercise tests were evaluated for all patients.
Results: Fifteen postmenopausal women with ADHF showed high incidence of osteoporosis (40.0%, volumetric lumbar BMD < 80 mg/cm3) and osteopenia (33.3%, BMD of 80-120 mg/cm3). Among fifty male patients, sixteen patients (32%) had osteopenia and six patients (12%) had osteoporosis. C-telopeptide of type I collagen (0.564 ± 0.323 ng/mL) was within normal range, however osteocalcin (18.7 ± 23.2 ng/mL) and 25-hydroxyvitamin D (13.8 ± 7.0 ng/mL) were low, while parathyroid hormone (65.3 ± 41.0 pg/mL) was increased. Lumbar BMD was lower in ischemic patients than non-ischemic patients (107.9 ± 47.5 mg/cm3 vs. 145.4 ± 40.9 mg/cm3, p=0.005). When controlled for age, body mass index, N-terminal proBNP, etiology of heart failure, hemoglobin and thigh circumference, multivariate regression analysis revealed peak VO2 independently predicts lumbar BMD (β=0.448, p=0.031), hip total BMD (β=0.547, p=0.021), femur total cortical thickness (β=0.595, p=0.011) and femur neck cortical thickness (β=0.590, p=0.011).
Conclusion: Osteoporosis is more prevalent in ischemic patients and exercise capacity independently predicts BMD in male ADHF patients. Proper osteoporosis evaluation is necessary in male ADHF patients as well as postmenopausal patients.
Author Disclosures: J. Youn: None. Y. Rhee: None. J. Oh: None. N. Hong: None. S. Park: None. S. Lee: None. D. Choi: None. S. Kang: None.
- © 2014 by American Heart Association, Inc.