Congestive heart failure is associated with the rate of bone loss

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Abstract
Nishio K, Mukae S, Aoki S, Itoh S, Konno N, Ozawa K, Satoh R, Katagiri T (School of Medicine Showa University, Hatanodai, Shinagawa‐ku, Tokyo, Japan). Congestive heart failure is associated with the rate of bone loss. J Intern Med 2003; 253: 439–446. Aims. To characterize relationships between mineral homeostasis, bone turnover, bone mass, and congestive heart failure (CHF), we evaluated 75 women with mild to moderate CHF. Methods and results. We examined the association in annual rate of change in spinal bone mineral density (BMD) with polymorphism of the vitamin D receptor (VDR) gene. Compared with the control group, the CHF group had reduced left ventricular ejection fraction (LVEF: 68.2 ± 7.5% vs. 60.2 ± 12.9%; P = 0.0249), human atrial natriuretic peptide (hANP) was elevated (hANP: 10.7 ± 4.7 pmol L−1 vs. 25.8 ± 24.2 pmol L−1; P = 0.001) and had lower peak VO2 (22.3 ± 7.5 mL kg−1 min−1 vs. 15.8 ± 7.4 mL kg−1 min−1; P = 0.0429). The CHF patients with the VDR FF genotype had a significantly high annual rate of decrease in BMD. In the CHF patients with the VDR FF genotype, urinary calcium excretion (FECa) was elevated (1.40 ± 0.91% vs. 2.39 ± 1.40%; P = 0.028), and serum bone‐type alkaline phosphatase (B‐ALP) was reduced (62.6 ± 13.7 IU L−1 vs. 47.0 ± 18.6 IU L−1; P = 0.0123). Also, FECa was correlated positively with furosemide dose (R = 0.881; P = 0.0087) and hANP concentrations (R = 0.635; P = 0.0147) and negatively with ΔBMD (R = 0.72; P = 0.044) in the CHF patients with the VDR FF genotype. Conclusion. The CHF patients with the VDR FF genotype have higher rates of bone loss. These patients may need to increase their calcium intake and BMD may need to be followed more carefully over time.