Status of bone mineral density in patients selected for cardiac transplantation.
OBJECTIVE
To determine the prevalence and correlates of low bone mineral density (BMD) in ambulatory outpatients with end-stage heart failure who were awaiting cardiac transplantation.


METHODS
Fifty-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.


RESULTS
The 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.


CONCLUSIONS
Lumbar spine and hip BMD measurements were not significantly low relative to age and sex in ambulatory patients with heart failure awaiting cardiac transplantation.
Iqbal
Nayyar
N
Division of Endocrinology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania Section of Endocrinology, Department of Medicine, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA 19104, USA.
Ducharme
Julie
J
Desai
Shashank
S
Chambers
Susan
S
Terembula
Karen
K
Chan
Grace W
GW
Shults
Justine
J
Leonard
Mary B
MB
Kumanyika
Shiriki
S
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D015519:Bone Density / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging; D016027:Heart Transplantation; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging; D010281:Parathyroid Hormone / Q000097:blood; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood
D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D