[Bone Metabolism and Mineral Density in Chronic Heart Failure].

PURPOSE: to assess the state of bone metabolism and mineral density in outpatients with chronic heart failure (CHF).

MATERIAL AND METHODS: We examined 70 outpatients (30 men, 40 women, aged 56-88 years) with CHF and 40 outpatients without CHF (10 men, 30 women, aged 57-88 years). Examination included laboratory assessment, echocardiography, study of bone mineral density (BMD) in the lumbar spine and femoral neck using dual-energy X-ray absorptiometry.

RESULTS: Osteoporosis was recorded in 61.4 and 32.4%, osteopenia - in 20 and 42.5%, normal BMD - in 18.6 and 25% of patients with and without CHF, respectively. A total of 24.3 and 7.5% of patients with and without CHF, respectively, experienced various bone fractures during mean follow up of 26.5 months. Significant correlation was established between osteoporosis and patient's age (r=0.36; p=0.002), CHF duration (r=0.26; p=0.039), falls (r=0.29; p=0.015), fractures (r=0.42; <0.001), chronic kidney disease - CKD (r=0.24; =0.048), N-proBNP (r=0.52; =0.007), GFR (r=-0.37; =0.010). In unifactorial analysis osteoporosis was associated with CKD (odds ratio [R] 3.1, 95% confidence interval [CI] 1.1-8.8, p=0.032 , N-proBNP (R 9.8, 95% CI 1.1-8.9, =0.043) and frequent alls (R 4.0, 95% CI 1.3-12.7; =0.019).

CONCLUSIONS: Association of high N-proBNP level and abnormal renal function with lowered BMD allows to suggest that low BMD is an independent marker of CHF severity, and patients with CHF are at high risk of osteoporosis and related fractures.