Abstract
Abstract Disclosure: F. Bandeira: None. L.B. Oliveira: None. M.A. Siqueira: None. M.A. Litvin: None. J.M. Garcia: None. L. Bandeira: None. Introduction: Heart failure (HF) is a clinical syndrome directly associated with functional impairment, which may be interrelated with skeletal consequences and an increased risk of fractures. The trabecular bone score (TBS) allows an indirect assessment of the bone microarchitecture, a helpful tool in fracture risk stratification. Objective: To evaluate the TBS and its relationship with bone mineral density (BMD) and cardiometabolic parameters in patients admitted with HF. Methods: Cross-sectional study was conducted in a Cardiology center, with patients aged 40 to 85 years hospitalized with HF. Clinical, echocardiographic, laboratory and BMD were evaluated. TBS <1.230 was characterized as bone degradation. Results: A total of 103 patients were evaluated, of which 53.4% were female. The mean age was 64.1 ± 9.4 years. The median left ventricular ejection fraction (LVEF) was 50.0% (interquartile range [IQR] 34.0-61.0%), with 50.5% having preserved LVEF (≥50%), 5.8% having mildly reduced LVEF (41-49%), and 43.7% having reduced LVEF (≤40%). 50.4% of patients had New York Heart Association Functional Classification (NYHA-FC) I-II and 49.6% NYHA-FC III-IV. The majority (67%) of patients had HF of ischemic etiology; 43.7% had diabetes mellitus and 30.0% had prediabetes. Bone degradation indicated by TBS was present in 33.0% of the sample, while BMD in the osteoporosis range was observed in 22.3%. There was no statistically significant difference between genders in the presence of bone degradation (22.9% of men vs. 36.4% of women, p = 0.138). Low TBS was associated with higher mean age (67.5 ± 9.1 vs. 62.7 ± 9.2 years, p = 0.016) and lower T-scores in the lumbar spine (−1.9 ± 1.3 vs. −0.7 ± 1,8, p = 0.001), femoral neck (−1.6 ± 1.2 vs. −1.1 ± 1.2, p = 0.030), and total femur (−1.3 ± 1.1 vs. −0.5 ± 1.3, p = 0.005). There was no association between low TBS and body mass index (28.0 ± 4.4 vs. 27.8 ± 5.3 kg/m², p = 0.828), LVEF (50.0% [30.0-59.0] vs. 55.0% [34.3-61.8], p = 0.183) and hemoglobin A1c (6.4% [5.7-7.9] vs. 6.2% [5.7-8.2], p = 0.920). Patients with NYHA-FC III-IV had lower mean TBS when compared to those with NYHA-FC I-II (1.273 ± 0.138 vs. 1.335 ± 0.149, p = 0.031). Conclusion: We found that bone microarchitecture deterioration was more frequent than osteoporosis in patients hospitalized with HF, with greater symptomatology being associated with lower TBS. Presentation: Thursday, June 15, 2023
Published Version
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