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心力衰竭严重程度对老年心力衰竭患者骨密度的影响。

Impact of heart failure severity on bone mineral density among older patients with heart failure.

机构信息

Department of Rehabilitation, Fujita Health University Bantane Hospital, Nagoya, Japan.

Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan.

出版信息

Heart Vessels. 2021 Dec;36(12):1856-1860. doi: 10.1007/s00380-021-01884-1. Epub 2021 Jun 3.

Abstract

The study aimed to identify factors related to bone mineral density (BMD) among older patients with heart failure (HF). A total of 70 consecutive patients with HF aged 65 years or older who were admitted to an acute hospital due to worsening condition were enrolled before discharge. BMD of the femoral neck was evaluated using the DEXA method. Physical function, as well as echocardiographic and laboratory findings including biomarker of HF severity were collected. Bivariate and multiple regression analyses were employed to determine the association between BMD and the clinical variables. Bivariate analysis determined that age, grip strength, walking speed, serum albumin, and N-terminal pro B-type natriuretic peptide (NT-proBNP) were significantly correlated with BMD (P < 0.01), whereas other clinical parameters were not. The multiple regression analysis identified NT-proBNP as an independent related factor for BMD after adjusting with confounding clinical variables. NT-proBNP was independently related to BMD among older patients with HF. Our results suggest the inclusion of bone fracture prevention strategies in disease management programs, especially for older patients with HF.

摘要

本研究旨在确定与心力衰竭(HF)老年患者骨密度(BMD)相关的因素。在出院前,共纳入 70 名因病情恶化而入住急性医院的年龄在 65 岁或以上的 HF 连续患者。使用 DEXA 方法评估股骨颈的 BMD。收集了身体功能以及超声心动图和实验室检查结果,包括 HF 严重程度的生物标志物。采用双变量和多元回归分析确定 BMD 与临床变量之间的关联。双变量分析确定年龄、握力、步行速度、血清白蛋白和 N 末端 pro B 型利钠肽(NT-proBNP)与 BMD 显著相关(P<0.01),而其他临床参数则不相关。在调整混杂的临床变量后,多元回归分析确定 NT-proBNP 是 BMD 的独立相关因素。NT-proBNP 与 HF 老年患者的 BMD 独立相关。我们的研究结果表明,应在疾病管理计划中纳入骨折预防策略,尤其是针对 HF 老年患者。

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