Skip to main content

Advertisement

SpringerLink
Log in

Bone Mineral Density and Metabolism in Very Elderly Patients with Congestive Heart Failure

  • Medicine
  • Published:
SN Comprehensive Clinical Medicine Aims and scope Submit manuscript

Abstract

The study purpose was investigation of bone mineral density (BMD) and metabolism in very elderly patients with heart failure. The study enrolled 125 patients (aged 75–98 years) hospitalized with coronary artery disease (CAD). The study group comprised 61 patients with clinically significant congestive heart failure (CHF) and the control group — 64 age-matched patients without CHF symptoms. The main exclusion criteria were any other diseases that could cause osteoporosis and administration of medications reducing BMD. Lumbar spine and proximal femur BMD was measured by dual-energy X-ray absorptiometry. Serum osteocalcin concentration was measured by immunechemiluminescence, beta-Cross Laps level — by electrochemiluminescence. BMD in the CHF patients was lower versus the control group. Largest differences were recorded in proximal femur: BMD in the CHF patients was 719.8 ± 188.2 mg/cm3 versus 797.7 ± 161.7 mg/cm3 (p = 0.02) in the control group. Greater differences in BMD were detected in female patients. Proximal femur BMD had normal values only in 5% of the CHF patients, in the control group — in 31% of cases (p = 0.003). Reduced osteoblast function was observed in CHF patients: the mean osteocalcin level in the CHF patients was 1.2 ± 1.7 ng/ml versus 4.2 ± 4.1 ng/ml (р = 0.03) in the control group. Mean β-Cross Laps level in the CHF patients reached 0.73 ± 0.4 ng/ml versus 0.4 ± 0.1 ng/ml (p = 0.003) in the control group. These study findings suggest that bone mineral density in very elderly CHF patients is noticeably lower versus the patient group similar in age and main diseases. This study has demonstrated significantly reduced osteoblast function in CHF patients and slight increase in bone resorption.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure. The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Eur Heart J. 2016;37(27):2129–200.

    Article  Google Scholar 

  2. Cleland JG, McDonagh T, Rigby AS, et al. The National Heart Failure Audit for England and Wales 2008-2009. Heart. 2011;97(11):876–86.

    Article  PubMed  Google Scholar 

  3. Mosterd A, Hoes AW. Clinical epidemiology of heart failure. Heart. 2007;93(9):1137–46.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Bleumink GS, Knetsch AM, Sturkenboom MCJM, et al. Quantifying the heart failure epidemic: prevalence, incidence rate, lifetime risk and prognosis of heart failure: the Rotterdam study. Eur Heart J. 2004;25(18):1614–9.

    Article  PubMed  Google Scholar 

  5. The Eastern European & Central Asian Regional Audit. Epidemiology, costs & burden of osteoporosis in 2010. Available at: https://www.iofbonehealth.org/sites/default/files/PDFs/Audit%20Eastern%20Europe_Central%20Asia/Eastern_European_Central_Asian_Audit_2010.pdf (accessed 27 Nov 2018).

  6. Osteoporosis. Epidemiology. International Osteoporosis Foundation. Available at: https://www.iofbonehealth.org/epidemiology (accessed 15 Oct 2018).

  7. Carbone L, Buzkova P, Fink HA, Lee JS, Chen Z, Ahmed A, et al. Hip fractures and heart failure: findings from the Cardiovascular Health Study. Eur Heart J. 2010;31(1):77–84.

    Article  PubMed  Google Scholar 

  8. Frost RJA, Sonne C, Wehr U. Effects of calcium supplementation on bone loss and fractures in congestive heart failure. Eur J Endocrinol. 2007;156:309–14.

    Article  CAS  PubMed  Google Scholar 

  9. Mazziotti G, Baracca M, Doga M, Porcelli T, Vescovi PP, Giustina A. Prevalence of thoracic vertebral fractures in hospitalized elderly patients with heart failure. Eur J Endocrinol. 2012;167:865–72.

    Article  CAS  PubMed  Google Scholar 

  10. Jankowska EA, Jakubaszko J, Owynar A, et al. Bone mineral status and bone loss over time in men with chronic systolic heart failure and their clinical and hormonal determinants. Eur J Heart Fail. 2009;11(1):28–38.

    Article  CAS  PubMed  Google Scholar 

  11. Santangelo A, Testai M, Mamazza G, et al. The bone mass (BM) and chronic cardiac decompensation (CCD) in an elderly population. Arch Gerontol Geriatr. 2011;53(1):51–4.

    Article  PubMed  Google Scholar 

  12. Aluoch AO, Jessee R, Habal H, Garcia-Rosell M, Shah R, Reed G, et al. Heart failure as a risk factor for osteoporosis and fractures. Curr Osteoporos Rep. 2012;10(4):258–69.

    Article  PubMed  Google Scholar 

  13. Farhat GN, Cauley JA. The link between osteoporosis and cardiovascular disease. Clin Cases Miner Bone Metab. 2008;5(1):19–34.

    PubMed  PubMed Central  Google Scholar 

  14. Terrovitis J, Zotos P, Kaldara E, Diakos N, Tseliou E, Vakrou S, et al. Bone mass loss in chronic heart failure is associated with secondary hyperparathyroidism and has prognostic significance. Eur J Heart Fail. 2012;14(3):326–32.

    Article  CAS  PubMed  Google Scholar 

  15. FRAX. https://www.shef.ac.uk/FRAX/tool.aspx?country=13 (accessed 22 Sept 2018).

  16. Kenny AM, Boxer R, Walsh S, Hager WD, Raisz LG. Femoral bone mineral density in patients with heart failure. Osteoporos Int. 2006;17(9):1420–7.

    Article  CAS  PubMed  Google Scholar 

  17. Majumdar SR, Ezekowitz JA, Lix LM, Leslie WD. Heart failure is a clinically and densitometrically independent risk factor for osteoporotic fractures: population-based cohort study of 45509 subjects. J Clin Endocrinol Metab. 2012;97:1179–86.

    Article  CAS  PubMed  Google Scholar 

  18. Gullestad L, Ueland T, Vinge LE, Finsen A, Yndestad A, Aukrust P. Inflammatory cytokines in heart failure: mediators and markers. Cardiology. 2012;122:23–35.

    Article  CAS  PubMed  Google Scholar 

  19. Glendenning P, Kent GN, Adler BD, et al. High prevalence of osteoporosis in cardiac transplant recipients and discordance between biochemical turnover markers and bone histomorphometry. Clin Endocrinol. 1999;50(3):347–55.

    Article  CAS  Google Scholar 

  20. Lencel P, Magne D. Inflammaging: the driving force in osteoporosis? Med Hypotheses. 2011;76:317–21.

    Article  CAS  PubMed  Google Scholar 

  21. Wang RT, Li XS, Zhang JR, Sun Y, Yu KJ, Liu T. Bone mineral density is associated with left ventricular diastolic function in women. Clin Cardiol. 2016. n/a;39:709–14. https://doi.org/10.1002/clc.22592.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Murdoch DR, Rooney E, Dargie HJ, Shapiro D, Morton JJ, McMurray JJV. Inappropriately low plasma leptin concentration in the Cachexia associated with chronic heart failure. Heart. 1999;82:352–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Baig M., Tariq S.. Homocysteine and leptin in the pathogenesis of osteoporosis – evidences, conflicts and expectations. In Advances in osteoporosis, PhD. Yannis Dionyssiotis (Ed.), InTech, 2015. DOI: https://doi.org/10.5772/59869. Available at: http://www.intechopen.com/books/advances-in-osteoporosis/homocysteine-and-leptin-in-the-pathogenesis-of-osteoporosis-evidences-conflicts-and-expectations (accessed 14 Nov 2018).

  24. Topolyanskaya SV, Osipovskaya IA, Lifanova LS, et al. Bone mineral density and metabolism in very elderly patients with congestive heart failure. Eur J Heart Fail. 2018;20(Suppl.S1):96 P407.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hospital Therapy Department No.2, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

    S. V. Topolyanskaya, L. S. Lifanova & L. I. Dvoretsky

  2. War Veterans Hospital (WVH) No.3, Moscow, Russia

    I. A. Osipovskaya, T. A. Eliseeva & O. N. Vakulenko

Authors
  1. S. V. Topolyanskaya
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. I. A. Osipovskaya
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L. S. Lifanova
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. T. A. Eliseeva
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. O. N. Vakulenko
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. L. I. Dvoretsky
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. V. Topolyanskaya.

Ethics declarations

Conflict of Interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical Approval

All procedures conducted in the study complied with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study. This study was approved by the Independent Review Board; the IRB approval number is 05-2017.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Medicine

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Topolyanskaya, S.V., Osipovskaya, I.A., Lifanova, L.S. et al. Bone Mineral Density and Metabolism in Very Elderly Patients with Congestive Heart Failure. SN Compr. Clin. Med. 1, 451–457 (2019). https://doi.org/10.1007/s42399-019-00065-6

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s42399-019-00065-6

Keywords

Search

Navigation