Kalp Yetersizliği Olan Geriatrik Hastalarda Kemik Mineral Dansitometri ve Kalça Kırıklarının Değerlendirilmesi

Year 2019, , 242 - 246, 28.06.2019

Arslan Kağan Arslan , Hatice Tolunay

https://doi.org/10.18521/ktd.538977

Abstract

Analysis of Bone Mineral Density and Hip Fracture in Geriatric Patients with Heart Failure

Abstract

Objectives: Osteoporosis
defined by low Bone Mineral Density (BMD), is a progressive disease affecting
especially older adults. Hip fracture is the important result of osteoporosis.  For the older adults, heart failure (HF) and
osteoporosis are two common chronic conditions that are gaining importance for
healthcare. The aim of this study is to evaluate bone mineral density and hip
fractures in geriatric aged patients with heart failure

Methods: We retrospectively analyzed 157 geriatric
patients with heart failure and 155 geriatric control subjects without any
cardiovascular disease and risk factors. All subjects underwent transthoracic
echocardiography, biochemical analysis, and bone DEXA study. Osteoporotic
fracture history and operation for fracture, list of current and prior use of
medications were obtained from each center’s medical recordings.

Results: Among the 157 patients, 45 (29%) had normal
BMD, 14 (9%) had osteopenia, and 98 (62%) had osteoporosis.  In 155 control subjects,68 (44%) had normal
BMD, 12 (8%) had osteopenia, and 75 (46%) had osteoporosis (P=0.019). Sixteen
subjects (10.2%) in heart failure group and 6 subjects (3.9%) in controls had
hip fracture (p=0.029). Level of 25-hydroxyvitamin D was significantly lower in
heart failure than in controls (15.1±10.2 vs. 29.1±20.4 ng/ml; p<0.001).

Conclusion: Patients with heart failure have a lower bone
mineral density, low vitamin D level and an increased rate of hip fractures.
These findings can be explained by shared risk factors and pathogenetic
mechanisms. Further prospective studies should be performed for evaluating the
role of heart failure in osteoporotic hip fractures.  

Keywords

Hip fracture, Osteoporosis, Bone Mineral Density, heart failure, vitamin D

References

• 1. Newman AB, Gottdiener JS, Mcburnie MA, Hirsch CH, Kop WJ, Tracy R, et al. Associations of subclinical cardiovascular disease with frailty. J Gerontol A Biol Sci Med Sci. 2001;56:M158-66.
• 2. Walston J, McBurnie MA, Newman A, Tracy RP, Kop WJ, Hirsch CH, et al. Frailty and activation of the inflammation and coagulation systems with and without clinical comorbidities: results from the Cardiovascular Health Study. Arch Intern Med. 2002;162:2333-41.
• 3. Kenny AM, Waynik IY, Smith J, Fortinsky R, Kleppinger A, McGee D. Association between level of frailty and bone mineral density in community-dwelling men. J Clin Densitom. 2006;9:309-14.
• 4. Cankurtaran M, Yavuz BB, Halil M, Dagli N, Ariogul S. General characteristics, clinical features and related factors of osteoporosis in a group of elderly Turkish men. Aging Clin Exp Res. 2005;17:108-15
• 5. Wiktorowicz ME, Goeree R, Papaioannou A, Adachi JD, Papadimitropoulos E. Economic implications of hip fracture: health service use, institutional care and cost in Canada. Osteoporos Int. 2001;12:271–278.
• 6. Yesil Y, Ulger Z, Halil M, Halaclı B, Yavuz BB, Yesil NK, et al. Coexistence of osteoporosis (OP) and coronary artery disease (CAD) in the elderly: It is not just a by chance event. Arch Gerontol Geriatr. 2012;54:473-6.
• 7. Genant HK, Cooper C, Poor G, Reid I, Ehrlich G, Kanis J, et al. Interim report and recommendations of the World Health Organization Task-Force for Osteoporosis. Osteoporos Int. 1999;10:259-64.
• 8. van Diepen S, Majumdar SR, Bakal JA, McAlister FA, Ezekowitz JA. Heart failure is a risk factor for orthopedic fracture: a population-based analysis of 16,294 patients. Circulation. 2008;118:1946-52
• 9. Carbone L, Buzková 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;31:77-84.
• 10. Cetin M, Kozdağ G, Ural D, Kahraman G, Yılmaz I, Akay Y, et al. Could decreased vitamin D levels be related with impaired cardiac autonomic functions in patients with chronicheart failure: an observational study. Anadolu Kardiyol Derg. 2014;14:434-41.
• 11. Anagnostis P, Karagiannis A, Kakafika AI, Tziomalos K, Athyros VG, Mikhailidis DP. therosclerosis and osteoporosis: age-dependent degenerative processes or related entities? Osteoporos Int. 2009;20:197-207.
• 12. Eastell R, Newman C, Crossman DC. Cardiovascular disease and bone. Arch Biochem Biophys. 2010;503:78-83.
• 13. Manolagas SC. From estrogen-centric to aging and oxidative stress: a revised perspective of the pathogenesis of osteoporosis. Endocr Rev. 2010;31:266-300.