Bone mineral density in older patients with chronic heart failure is related to NYHA classification: a retrospective study

Purpose Discrepant results on relationship between chronic heart failure (CHF) and bone mineral density (BMD) have been reported and little has investigated the association between bone mass loss and New York Heart Association (NYHA) classification in CHF patients. This study aimed to assess whether BMD was associated with NYHA classification in older CHF patients. Methods It was a retrospective study and included 1049 stable CHF patients aged over 60 years in Zhejiang Hospital. BMD and T-score at femoral neck (FN) and lumbar spines over L2-L4 regions were measured using Dual-Energy X-ray Absorptiometry. One-way ANOVA was used to compare continuous data of different NYHA functional class. Categorical variables were compared by Chi-square analysis. Pearson or Spearman correlation test was used to analyze the association between BMD and NYHA class, clinical parameters, lab data, etc. Significant variables in the correlation test (P < 0.05) were then tested by a multivariate linear regression test with stepwise subset selection to identify independent factors predicting BMD. Results There were significant differences in FN BMD and T score across NYHA class I-IV, and that L2-L4 BMD and T score in patients in NYHA class IV were significantly lower when compared with CHF participants in NYHA classes I, II, and III. Moreover, Pearson correlation test and multivariate linear regression test demonstrated that there were statistically significant correlations between bone densitometric parameters and NYHA class. Conclusions There was a significant correlation between BMD and T-score at lumbar spines over L2-L4 and FN and NYHA class, implying that early screening and comprehensive intervention for osteoporosis (OP) might be helpful for patients with CHF.