Reduced Bone Mineral Density in Hypertensive Patients Is Associated with Left Ventricular Diastolic Dysfunction, Not Left Ventricular Hypertrophy
Reduced Bone Mineral Density in Hypertensive Patients Is Associated with Left Ventricular Diastolic Dysfunction, Not Left Ventricular Hypertrophy
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DOI：
10.3109/10641963.2011.577490
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发表时间：
2012-01-01
影响因子：
12.3
通讯作者：
Goda, Fuminori
中科院分区：
文献类型：
--
作者：
Masugata, Hisashi;Senda, Shoichi;Goda, Fuminori
左心室肥厚和舒张功能不全是高血压患者常见的并发症，是导致慢性心力衰竭的危险因素。最近，与健康对照组相比，高血压患者的骨密度降低。然而，骨密度与左室肥厚和舒张功能障碍之间的关系尚未得到充分评估。我们研究了38例接受抗高血压药物治疗至少1年的高血压患者（23例男性，15例女性;平均年龄71 ± 8岁）的骨矿物质密度与左室肥厚和舒张功能障碍之间的关系。使用定量超声测量装置（A-1000 EXPRESS/InSight，GE Healthcare，霍滕，Norway）测量跟骨的骨矿物质密度，并将刚度指数确定为骨矿物质密度的参数。进行超声心动图测量左心室质量指数作为LV肥大的参数。左室舒张功能障碍还通过舒张早期二尖瓣环流速（e '）和早期二尖瓣流速（E）与e'的比值（E/e '）进行评估。骨密度与左室重量指数无关，但与e'（r = 0.453，P <0.01）和E/e'（r =-0.359，P <0.05）相关。因此，高血压患者骨密度降低与左室肥厚无关，但与左室舒张功能障碍有关。骨密度降低的高血压患者由于左心室舒张功能障碍以及骨质疏松导致的骨折可能具有慢性心力衰竭的高风险。
Left ventricular (LV) hypertrophy and diastolic dysfunction are commonly observed in hypertensive patients, and have been demonstrated to be risk factors of chronic heart failure due to LV diastolic dysfunction. Recently, reduced bone mineral density has been found in hypertensive patients compared with healthy controls. However, relationships between bone mineral density and LV hypertrophy and diastolic dysfunction have not been fully assessed. We examined relationships between bone mineral density and both LV hypertrophy and diastolic dysfunction in 38 hypertensive patients (23 males, 15 females; mean age 71 +/- 8 y) who had been treated with antihypertensive drugs for at least 1 year. The bone mineral density of the calcaneus was measured with a quantitative ultrasound measurement device (A-1000 EXPRESS/InSight, GE Healthcare, Horten, Norway), and the stiffness index was determined as a parameter of bone mineral density. Echocardiography was performed to measure the left ventricular mass index as a parameter of LV hypertrophy. Left ventricular diastolic dysfunction was also assessed by early diastolic mitral annular velocity (e'), and the ratio of early transmitral flow velocity (E) to e' (E/e'). The bone mineral density did not correlate with left ventricular mass index, but did correlate with e' (r = 0.453, P < .01) and E/e' (r = -0.359, P < .05). Thus, reduced bone mineral density in hypertensive patients is not associated with LV hypertrophy but with LV diastolic dysfunction. Hypertensive patients with reduced bone mineral density may have a high risk of chronic heart failure due to LV diastolic dysfunction as well as bone fractures due to osteoporosis.