Relationship between various measures of bone mineral density and vertebral fractures in cardiac transplant recipients.
BACKGROUND
The incidence rates of osteoporosis and fractures are increased after cardiac transplantation.


METHODS
We performed a cross-sectional analysis of cardiac transplant recipients in a late post-transplantation period (4.4 [2.5] years after cardiac transplantation, n = 27). We measured bone mineral density (BMD) by DXA at the hip and lumbar spine and by quantitative ultrasound (QUS) at the calcaneus. Vertebral fracture (vfx) prevalence was analysed by anterior-posterior and lateral radiographs of the thoracic and lumbar spine.


RESULTS
Overall, vfx were present in 13 of 27 patients (48.2%, n = 51 vfx). Vfx were observed in 1 out of 5 patients with normal DXA results, 7 out of 14 osteopenic and 5 out of 8 osteoporotic cardiac transplant recipients. BMD at the femoral neck and more prominently at Ward's triangle were significantly lower in vfx patients compared to patients without vfx, with adjusted mean values (95% CI) of 0.804 [0.750-0.859] vs. 0.915 [0.860-0.969] g/cm2 and 0.573 [0.501-0.646] vs. 0.766 [0.697-0.836] g/cm2, respectively.


CONCLUSIONS
These findings suggest an association between DXA measurements of the hip with vertebral fractures in a late post-transplantation period and thus extend knowledge from previous reports on cardiac transplant recipients studied earlier after CTX. In particular, our data pinpoint a potentially interesting role for BMD at Ward's triangle.
Höfle
G
G
Department of Internal Medicine and Vorarlberg Institute for Vascular Investigation and Treatment, Landeskrankenhaus Feldkirch, Austria. guenter.hoelfe@lkhf.at
Saely
C H
CH
Tautermann
G
G
Aczél
S
S
Holzmüller
H
H
Drexel
H
H
D015502:Absorptiometry, Photon; D015519:Bone Density; D003430:Cross-Sectional Studies; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology* / Q000209:etiology / Q000378:metabolism; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015995:Prevalence; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D014463:Ultrasonography