Giaquinto Alfonso, Abate Veronica, Vergatti Anita, Muscariello Riccardo, Iervolino Adelaide, Pucci Martina, Cavati Guido, Pirrotta Filippo, De Filippo Gianpaolo, Esposito Roberta, D'Elia Lanfranco, Merlotti Daniela, Gennari Luigi, Rendina Domenico
Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy.
J Intern Med. 2025 Jun;297(6):630-641. doi: 10.1111/joim.20069. Epub 2025 May 8.
Paget's disease of the bone (PDB) is a metabolic bone disorder involving one or more skeletal sites. Cardiovascular diseases (CVDs) have been described in patients with PDB but have not been systematically analysed.
This study aimed to compare standard and advanced (speckle-tracking) echocardiographic parameters measured in patients with PDB and controls matched for age, weight, height and history of hypertension but without metabolic bone disorders.
This multicentre case-control study included all patients with PDB referred to the Federico II and Siena Universities, Italy, from March 2019 to October 2022. During the same time, we enrolled at least one control for each patient, matched for age, sex, body mass index (BMI) and history of hypertension.
Sixty-nine patients with PDB and 115 healthy controls were enrolled in this study. All patients with PDB were treated with zoledronic acid at the time of diagnosis. Compared with controls, on standard echocardiography, patients with PDB showed a high prevalence of aortic and mitral valve calcifications and/or sclerosis, reduced left ventricular (LV) ejection fraction, stroke volume, cardiac output, increased interventricular septum thickness, posterior wall thickness, LV mass index, relative wall thickness, relative diastolic wall thickness, E/e' ratio and systemic vascular resistance. Using speckle-tracking echocardiography, patients with PDB showed a lower global longitudinal strain and global myocardial work efficiency than controls. There was no relationship between the PDB activity and extent and severity of cardiac abnormalities.
Overall, the myocardial function and structure were impaired in patients with PDB. Additionally, PDB was associated with early subclinical myocardial damage.
骨佩吉特病（PDB）是一种累及一个或多个骨骼部位的代谢性骨病。心血管疾病（CVD）在PDB患者中已有报道，但尚未进行系统分析。
本研究旨在比较PDB患者与年龄、体重、身高和高血压病史相匹配但无代谢性骨病的对照组患者的标准和高级（斑点追踪）超声心动图参数。
这项多中心病例对照研究纳入了2019年3月至2022年10月期间转诊至意大利费德里科二世大学和锡耶纳大学的所有PDB患者。同时，我们为每位患者至少招募一名年龄、性别、体重指数（BMI）和高血压病史相匹配的对照。
本研究纳入了69例PDB患者和115例健康对照。所有PDB患者在诊断时均接受唑来膦酸治疗。与对照组相比，在标准超声心动图检查中，PDB患者主动脉瓣和二尖瓣钙化和/或硬化的患病率较高，左心室（LV）射血分数、每搏输出量、心输出量降低，室间隔厚度、后壁厚度、LV质量指数、相对壁厚度、相对舒张期壁厚度、E/e'比值和全身血管阻力增加。使用斑点追踪超声心动图，PDB患者的整体纵向应变和整体心肌工作效率低于对照组。PDB的活动程度与心脏异常的严重程度之间没有关系。
总体而言，PDB患者的心肌功能和结构受损。此外，PDB与早期亚临床心肌损伤有关。
