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

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

Research output: Contribution to journalArticle

Abstract

Summary: 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/cm3, 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.

Original languageEnglish
Pages (from-to)2121-2129
Number of pages9
JournalOsteoporosis International
Volume26
Issue number8
DOIs
Publication statusPublished - 2015 Aug 25

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Thigh
Bone Density
Heart Failure
Osteoporosis
Exercise
Bone and Bones
Femur Neck
Tomography
Pelvic Bones
Osteoporotic Fractures
Metabolic Bone Diseases
Exercise Test
Oxygen Consumption
Hip
Hemoglobins
Body Mass Index
Multivariate Analysis
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism

Cite this

@article{e4dd6044723e4e379003ea380cbccea0,
title = "Exercise capacity independently predicts bone mineral density and proximal femoral geometry in patients with acute decompensated heart failure",
abstract = "Summary: 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/cm3, 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.",
author = "Youn, {J. C.} and Lee, {S. J.} and Lee, {H. S.} and J. Oh and N. Hong and S. Park and Lee, {S. H.} and D. Choi and Y. Rhee and Kang, {S. M.}",
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doi = "10.1007/s00198-015-3112-3",
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Exercise capacity independently predicts bone mineral density and proximal femoral geometry in patients with acute decompensated heart failure. / Youn, J. C.; Lee, S. J.; Lee, H. S.; Oh, J.; Hong, N.; Park, S.; Lee, S. H.; Choi, D.; Rhee, Y.; Kang, S. M.

In: Osteoporosis International, Vol. 26, No. 8, 25.08.2015, p. 2121-2129.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Exercise capacity independently predicts bone mineral density and proximal femoral geometry in patients with acute decompensated heart failure

AU - Youn, J. C.

AU - Lee, S. J.

AU - Lee, H. S.

AU - Oh, J.

AU - Hong, N.

AU - Park, S.

AU - Lee, S. H.

AU - Choi, D.

AU - Rhee, Y.

AU - Kang, S. M.

PY - 2015/8/25

Y1 - 2015/8/25

N2 - Summary: 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/cm3, 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.

AB - Summary: 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/cm3, 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.

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JO - Osteoporosis International

JF - Osteoporosis International

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