[Clinical factors associated with bone mass loss previous cardiac transplantation].
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.


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.
García Delgado
I
I
Servicio de Rehabilitación, Hospital Universitario 12 de Octubre, Madrid.
Gil-Fraguas
L
L
Robles
E
E
Martínez
G
G
Hawkins
F
F
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000503:physiopathology; D002112:Calcifediol / Q000097:blood; D002118:Calcium / Q000097:blood / Q000652:urine; D005260:Female; D005272:Femur Neck / Q000503:physiopathology*; D006331:Heart Diseases / Q000097:blood / Q000503:physiopathology*; D016027:Heart Transplantation; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000097:blood / Q000209:etiology / Q000503:physiopathology*
D015415:Biomarkers; D002112:Calcifediol; D002118:Calcium