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[Clinical factors associated with bone mass loss previous cardiac transplantation]
I García Delgado1, L Gil-Fraguas, E Robles
1Servicio de Rehabilitación, Hospital Universitario 12 de Octubre, Madrid.
Insights
Patients awaiting cardiac transplantation experience decreased bone mineral density, with longer disease duration being a key factor in bone loss. Osteoporosis is prevalent, suggesting a need for early intervention.
Area of Science:
- Endocrinology
- Orthopedics
- Cardiology
Context:
- Cardiac transplantation candidates often exhibit reduced bone mineral density (BMD).
- Clinical factors contributing to bone loss in this population remain incompletely understood.
- Understanding these factors is crucial for managing bone health in end-stage heart disease.
Purpose:
- To assess lumbar and hip BMD in patients awaiting cardiac transplantation.
- To identify clinical and biochemical factors associated with reduced bone mass.
- To investigate the relationship between disease duration and bone loss.
Summary:
- A study of 51 cardiac transplant candidates revealed significantly lower BMD at the lumbar spine and hip compared to the general population.
- Osteoporosis prevalence was high (27.4%), with longer disease duration identified as the primary predictor of bone loss.
- Elevated bone turnover, characterized by increased resorption markers, was observed, while BMI showed a protective effect against osteoporosis.
Impact:
- Highlights the significant prevalence of osteoporosis and decreased bone mass in patients with cardiac failure awaiting transplantation.
- Identifies disease duration as a critical factor in the development of metabolic bone disease in this cohort.
- Suggests potential therapeutic targets and the importance of monitoring bone health in pre-transplant cardiac patients.
Background:
A high prevalence of osteoporosis has been described in patients before and after cardiac transplantation. But clinical factors involved in previous bone loss in this condition are not well known. The purpose has been to study bone mineral density (BMD) in patients subject to cardiac transplantation, analyzing clinical and biochemical factors related to bone mass in these patients.
Patients And Methods:
We have studied lumbar and hip BMD in 51 patients candidates to cardiac transplantation, evaluating the functional grade of the cardiopathy, time of evolution of the disease, and antropometric and biochemical markers of bone turnover. BMD was measured using a dual X ray densitometer.
Results:
A significant decrease in bone mass at lumbar and hip sites was found in patients with regard to normal population. A high prevalence of osteoporosis was found (27.4%). Time of evolution of the disease prior to transplantation was found to be the most important predictive variable in bone loss at trabecular bone (lumbar spine). No modifications were found in blood routine parameters, mineral studies and in serum intact PTH. Resorption bone markers were increased and formation markers were normal, suggesting a elevated turnover osteoporosis. Patients with osteoporosis had less BMI that patients without, indicating a protective effect of body mass. Patients with osteoporosis also had a greater time of evolution of the disease.
Conclusions:
There is a decreased bone mass in lumbar spine and hip and a higher prevalence of osteoporosis in patients with cardiac failure before cardiac transplantation. Time of waiting for cardiac transplantation has been an important factor found in the development of metabolic bone disease in these patients.