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Status of bone mineral density in patients selected for cardiac transplantation
Journal article   Peer reviewed

Status of bone mineral density in patients selected for cardiac transplantation

Nayyar Iqbal, Julie Ducharme, Shashank Desai, Susan Chambers, Karen Terembula, Grace W Chan, Justine Shults, Mary B Leonard and Shiriki Kumanyika
Endocrine practice, v 14(6), pp 704-712
01 Sep 2008
DOI: https://doi.org/10.4158/EP.14.6.704
PMID: 18996789

Abstract

OBJECTIVETo determine the prevalence and correlates of low bone mineral density (BMD) in ambulatory outpatients with end-stage heart failure who were awaiting cardiac transplantation. METHODSFifty-five cardiac transplant candidates with end-stage heart failure were enrolled in this study. Bone mineral density at the lumbar spine and proximal femur was determined by dual-energy x-ray absorptiometry. Laboratory studies included serum alkaline phosphatase, calcium, intact parathyroid hormone, and 25-hydroxyvitamin D. RESULTSThe mean proximal femur and lumbar spine Z scores were 0.3 +/- 1.1 and 0.3 +/- 1.5, respectively. The mean BMD was not lower than that of the age-and sex-matched reference population. Z scores were less than -1 in 23% at the lumbar spine and 15% at the proximal femoral neck. On the basis of T scores, osteopenia (T scores between -1 and -2.5) was present in 24% (confidence interval, 13% to 35%) of patients at the lumbar spine and in 20% (confidence interval, 10% to 30%) at the proximal femur; osteoporosis (T scores of less than -2.5) was present in 4% of the study population. Half of the patients in this study sample had elevated intact parathyroid hormone levels, and a third of the patients had low 25-hydroxyvitamin D levels. CONCLUSIONLumbar spine and hip BMD measurements were not significantly low relative to age and sex in ambulatory patients with heart failure awaiting cardiac transplantation.

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