PMID- 18977041
OWN - NLM
STAT- MEDLINE
DCOM- 20091015
LR  - 20220318
IS  - 1872-6976 (Electronic)
IS  - 0167-4943 (Linking)
VI  - 49
IP  - 2
DP  - 2009 Sep-Oct
TI  - Osteoporosis and congestive heart failure (CHF) in the elderly patient: double 
      disease burden.
PG  - 250-254
LID - S0167-4943(08)00197-0 [pii]
LID - 10.1016/j.archger.2008.09.004 [doi]
AB  - The present study aimed to evaluate the association between osteoporosis and CHF 
      in elderly patients and to assess the effect of physical performance, vitamin D 
      levels, inflammatory markers on this association. One hundred and twenty-six 
      consecutive patients aged 65 years and above, with moderate to severe CHF who 
      presented to our institution for CHF management and 54 age- and sex-matched 
      controls were screened for osteoporosis. All patients were thoroughly 
      interrogated for cause of CHF, medications, smoking, alcohol use, additional 
      comorbidities and previous falls/fractures. A physical examination was performed 
      to assess CHF severity and New York Heart Association (NYHA) class. Bone mineral 
      density (BMD) measurements using dual-energy X-ray absorptiometry (DXA) were 
      performed at the lumbar spine (LS) and femoral neck (FN). Physical performance 
      assessment included grip strength, 6-min walk, "Get up and Go Test", activities 
      of daily living (ADL) and frailty assessment. Biochemical assessment included 
      measurement of levels of serum calcium, phosphorus, 
      1,25-dihyroxycholecalciferol=1,25(OH)(2)D (vitamin D(3)) and tumor necrosis 
      factor-alpha (TNF-alpha). The BMD-Z-scores were significantly lower in HF 
      patients compared to the non-HF controls. Furthermore, there was an association 
      between the ejection fraction (EF) and the BMD-Z-scores. HF patients were 
      significantly more likely to have poor physical performance, a higher frailty 
      composite score, higher TNF-alpha and lower 1,25(OH)(2)D levels. A significant 
      association was found between EF and frailty score, p<0.001. The results suggest 
      that there is an association between HF and lower BMD. The increased bone loss in 
      conjunction with CHF is likely to increase fracture risk. Thus, strategies for 
      optimal treatment of CHF and for optimizing vitamin D(3), calcium and physical 
      activity to improve quality of life (QoL) in these patients who have double 
      disease burden are critical in these individuals.
FAU - Abou-Raya, Suzan
AU  - Abou-Raya S
AD  - Geriatric Unit, Internal Medicine Department, Faculty of Medicine, University of 
      Alexandria, 12 Heliopolis Street, Camp Cesar, 00203 Alexandria, Egypt. Electronic 
      address: suzanraya@yahoo.com.
FAU - Abou-Raya, Anna
AU  - Abou-Raya A
AD  - Rheumatology Unit, Internal Medicine Department, Faculty of Medicine, University 
      of Alexandria, 12 Heliopolis Street, Camp Cesar, 00203 Alexandria, Egypt.
LA  - eng
PT  - Journal Article
DEP - 20081031
PL  - Netherlands
TA  - Arch Gerontol Geriatr
JT  - Archives of gerontology and geriatrics
JID - 8214379
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 1C6V77QF41 (Cholecalciferol)
SB  - IM
MH  - Absorptiometry, Photon
MH  - Aged
MH  - Aged, 80 and over
MH  - Case-Control Studies
MH  - Cholecalciferol/blood
MH  - Female
MH  - Geriatric Assessment
MH  - Heart Failure/blood/*complications
MH  - Humans
MH  - Male
MH  - Osteoporosis/blood/*complications
MH  - Tumor Necrosis Factor-alpha/blood
EDAT- 2008/11/04 09:00
MHDA- 2009/10/16 06:00
CRDT- 2008/11/04 09:00
PHST- 2008/05/27 00:00 [received]
PHST- 2008/09/12 00:00 [revised]
PHST- 2008/09/16 00:00 [accepted]
PHST- 2008/11/04 09:00 [pubmed]
PHST- 2009/10/16 06:00 [medline]
PHST- 2008/11/04 09:00 [entrez]
AID - S0167-4943(08)00197-0 [pii]
AID - 10.1016/j.archger.2008.09.004 [doi]
PST - ppublish
SO  - Arch Gerontol Geriatr. 2009 Sep-Oct;49(2):250-254. doi: 
      10.1016/j.archger.2008.09.004. Epub 2008 Oct 31.