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Exercise capacity independently predicts bone mineral density and proximal femoral geometry in patients with acute decompensated heart failure

Authors
 J.-C. Youn  ;  S. J. Lee  ;  H. S. Lee  ;  J. Oh  ;  N. Hong  ;  S. Park  ;  S.-H. Lee  ;  D. Choi  ;  Y. Rhee , S.-M. Kang 
Citation
 OSTEOPOROSIS INTERNATIONAL, Vol.26(8) : 2121-2129, 2015 
Journal Title
 OSTEOPOROSIS INTERNATIONAL 
ISSN
 0937-941X 
Issue Date
2015
MeSH
Aged ; Aged, 80 and over ; Anthropometry/methods ; Bone Density/physiology* ; Exercise/physiology* ; Exercise Test/methods ; Female ; Femur/pathology* ; Femur Neck/physiopathology ; Heart Failure/complications* ; Heart Failure/epidemiology ; Heart Failure/pathology ; Heart Failure/physiopathology ; Humans ; Lumbar Vertebrae/physiopathology ; Male ; Middle Aged ; Osteoporosis/epidemiology ; Osteoporosis/etiology* ; Osteoporosis/pathology ; Osteoporosis/physiopathology ; Osteoporotic Fractures/epidemiology ; Osteoporotic Fractures/etiology ; Osteoporotic Fractures/pathology ; Osteoporotic Fractures/physiopathology ; Prevalence ; Prospective Studies ; Republic of Korea/epidemiology ; Tomography, X-Ray Computed
Keywords
Bone geometry ; Exercise capacity ; Heart failure ; Osteoporosis ; Quantitative computed tomography
Abstract
Heart failure is associated with increased risk of osteoporosis. We evaluated the prevalence and predictors of osteoporosis in hospitalized patients with ADHF using quantitative computed tomography. Osteoporosis and vertebral fracture are prevalent in patients with ADHF and exercise capacity independently predicts bone mass and femoral bone geometry. INTRODUCTION: Heart failure is associated with reduced bone mass and increased risk of osteoporotic fractures. However, the prevalence and predictors of osteoporosis in hospitalized patients with acute decompensated heart failure (ADHF) are not well understood. METHODS: Sixty-five patients (15 postmenopausal females and 50 males) with ADHF were prospectively and consecutively enrolled. After stabilization of heart failure symptoms, quantitative computed tomography for bone mineral density (BMD) and femoral geometry as well as biochemical, echocardiographic, and cardiopulmonary exercise tests were performed. RESULTS: Fifteen postmenopausal female showed a high prevalence of osteoporosis (40%) and vertebral fracture (53%). Among 50 male patients, 12% had osteoporosis and 32% had osteopenia, while vertebral fracture was found in 12%. Lumbar volumetric BMD (vBMD) was significantly lower in ischemic patients than non-ischemic patients (107.9 ± 47.5 vs. 145.4 ± 40.9 mg/cm(3), p = 0.005) in male. Exercise capacity, indicated by peak oxygen consumption (VO2), was significantly associated with lumbar vBMD (r = 0.576, p < 0.001) and total hip areal BMD (aBMD) (r = 0.512, p = 0.001) and cortical thickness of the femur neck (r = 0.544, p = 0.001). When controlled for age, body mass index, N-terminal proBrain natriuretic protein (NT-proBNP), etiology of heart failure, hemoglobin, and thigh circumference, multivariate regression analysis revealed peak VO2 independently predicted lumbar vBMD (β = 0.448, p = 0.031), total hip aBMD (β = 0.547, p = 0.021), and cortical thickness of the femur neck (β = 0.590, p = 0.011). CONCLUSION: In male patients with ADHF, osteoporosis and vertebral fracture are prevalent, and exercise capacity independently predicts bone mass and geometry. Given that heart failure patients with reduced exercise capacity carry a substantial increased risk of fracture, proper osteoporosis evaluation is important in these patients.
Full Text
http://link.springer.com/article/10.1007%2Fs00198-015-3112-3
DOI
10.1007/s00198-015-3112-3
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Oh, Jae Won(오재원) ORCID logo https://orcid.org/0000-0002-4585-1488
Youn, Jong Chan(윤종찬)
Lee, Sang Hak(이상학) ORCID logo https://orcid.org/0000-0002-4535-3745
Rhee, Yumie(이유미) ORCID logo https://orcid.org/0000-0003-4227-5638
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Nam Ki(홍남기) ORCID logo https://orcid.org/0000-0002-8246-1956
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/140130
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