Bone mass loss in chronic heart failure is associated with secondary hyperparathyroidism and has prognostic significance
| Autor: | Panagiotis Zotos, Eleni Karga, Stella Vakrou, John N. Nanas, John Terrovitis, S. T. Toumanidis, Athanasios N. Chalazonitis, Eleni Tseliou, Elissavet Kaldara, Nikolaos A. Diakos, Serafeim Nanas, Dimitrios A. Kontoyannis, Chris J. Kapelios |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Bone density Statistics as Topic Osteoporosis Parathyroid hormone Risk Assessment Statistics Nonparametric Ventricular Function Left Absorptiometry Photon Oxygen Consumption Bone Density Internal medicine Confidence Intervals Health Status Indicators Humans Medicine Vitamin D Bone mineral Heart Failure Diastolic Hyperparathyroidism business.industry Hazard ratio Stroke Volume Middle Aged Prognosis medicine.disease Myocardial Contraction Endocrinology Parathyroid Hormone Case-Control Studies Heart failure Disease Progression Cardiology Hyperparathyroidism Secondary Secondary hyperparathyroidism Heart-Assist Devices Cardiomyopathies Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Heart Failure. 14:326-332 |
| ISSN: | 1879-0844 1388-9842 |
| DOI: | 10.1093/eurjhf/hfs002 |
| Popis: | Aims Chronic heart failure (CHF) is associated with increased risk of osteoporosis. We investigated the relationship between severity of CHF and bone loss, underlying pathophysiological mechanisms, and the prognostic significance of bone mass changes in heart failure. Methods and results Total body (TB) and femoral (F) bone mineral density (BMD), and T- and Z-scores in the femur were measured in 60 men with CHF (56 ± 11 years) and 13 age-matched men free from CHF. The composite study endpoint was death, implantation of a left ventricular assist device (LVAD), or inotrope dependency during a median 2-year follow-up. Parathyroid hormone (PTH) and vitamin D were measured in all subjects. TBBMD, FBMD, T-score, and Z-score were significantly lower in men with CHF. Their PTH levels were also significantly increased (111 ± 59 vs. 39 ± 14; P < 0.001). Patients in New York Heart Association classes III–IV compared with those in classes I–II demonstrated significantly lower TBBMD, FBMD, T-score, and Z-score, and higher PTH (136 ± 69 vs. 86 ± 31; P= 0.001). Increased PTH levels were correlated with reduced TBBMD (P = 0.003), FBMD (P = 0.002), and femur T-score (P = 0.001), reduced cardiac index (P = 0.01) and VO2 peak (P < 0.0001), and increased wedge pressure (P = 0.001). Low TBBMD [hazard ratio (HR) 0.003, 95% confidence interval (CI) 0.00–0.58; P = 0.03] and Z-score (HR 0.56, 95% CI 0.35–0.90; P = 0.017) were associated with adverse outcome. Conclusions Secondary hyperparathyroidism and reduction in bone density occur in CHF patients and are associated with disease severity. Increased bone mass loss in CHF has prognostic significance. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|