From Aaron M, Hyder Joseph A, Kearns Ann M, Bailey Kent R, Pellikka Patricia A
Department of Internal Medicine, College of Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
Mayo Clin Proc. 2007 Jun;82(6):679-85.
To evaluate the relationship between bone mineral density (BMD) and ischemic heart disease and exercise capacity, as assessed by stress testing.
We retrospectively reviewed entries in the echocardiography database for 28,048 consecutive patients who underwent exercise echocardiography for standard clinical indications between August 1, 1998, and October 1, 2003, to determine which of these patients had also undergone dual-energy x-ray absorptiometry to measure femoral neck BMD before the procedure. Of the 1194 patients meeting both criteria, 28 were excluded because of missing data and 24 because they were tested with an exercise protocol other than the Bruce protocol, leaving 1142 patients to be included.
Of the included study patients, 643 (56%) had a T score of -1.0 or less (mean age +/- SD, 67 +/- 0 years; 87% women), and 499 (44%) had a T score greater than -1.0 (60 +/- 10 years; 90% women). For every 1-unit decrease in femoral neck T score, a 0.23 minute decrease in treadmill exercise duration was observed, once values had been adjusted for age and other patient characteristics (95% confidence interval [CI], 0.11-0.35; P<.001). Furthermore, for every 1-unit decrease in T score, there was a 22% increased risk of myocardial ischemia after adjustments (hazard ratio, 1.22; 95% CI, 1.06-1.41; P=.004). Overall, after adjustments, patients with a BMD of -1.0 or less who were referred for exercise echocardiography had a 43% greater risk of myocardial ischemia than did patients referred with normal BMD (hazard ratio, 1.43; 95% CI, 1.06-1.94; P=.02).
Lower BMD is associated with myocardial ischemia and decreased exercise capacity during exercise echocardiography. Persons with low BMD who present with symptoms suggestive of cardiovascular disease are more likely to have myocardial ischemia than are those with normal BMD.
通过压力测试评估骨密度（BMD）与缺血性心脏病及运动能力之间的关系。
我们回顾性分析了1998年8月1日至2003年10月1日期间因标准临床指征接受运动超声心动图检查的28048例连续患者的超声心动图数据库记录，以确定其中哪些患者在检查前还接受了双能X线吸收法测量股骨颈骨密度。在符合这两个标准的1194例患者中，28例因数据缺失被排除，24例因采用了除布鲁斯方案以外的运动方案进行测试被排除，最终纳入1142例患者。
在纳入研究的患者中，643例（56%）的T值为-1.0或更低（平均年龄±标准差，67±0岁；87%为女性），499例（44%）的T值大于-1.0（60±10岁；90%为女性）。在对年龄和其他患者特征进行校正后，股骨颈T值每降低1个单位，观察到跑步机运动持续时间减少0.23分钟（95%置信区间[CI]，0.11 - 0.35；P <.001）。此外，T值每降低1个单位，校正后心肌缺血风险增加22%（风险比，1.22；95% CI，1.06 - 1.41；P =.004）。总体而言，校正后，因运动超声心动图检查而就诊的骨密度为-1.0或更低的患者发生心肌缺血的风险比骨密度正常的患者高43%（风险比，1.43；95% CI，1.06 - 1.94；P =.02）。
较低的骨密度与运动超声心动图检查期间的心肌缺血及运动能力下降相关。出现心血管疾病症状的低骨密度患者比骨密度正常的患者更易发生心肌缺血。
