The interrelationship between the cardiovascular remodeling indicators and the state of bone mineral density in women with coronary artery disease
DOI:
https://doi.org/10.14739/2310-1237.2019.1.166296Keywords:
myocardial ischemia, postmenopause, osteoporosis, bone density, artrial remodeling, correlation of dataAbstract
Objective. To determine the peculiarities of the interrelationship between the cardiovascular remodeling indicators and the state of bone mineral density (BMD) in women with coronary artery disease (CAD).
Methods. A double open cross-sectional monocentric clinical study in parallel groups involved 115 women in postmenopausal period with coronary artery disease (CAD): stable exertional angina of II–III functional class. Depending on the BMD state they were divided into 3 groups: group 1 – 24 patients with normal BMD; group 2 – 34 patients with osteopenia; group 3 – 44 patients with osteoporosis. The BMD state was assessed with the help of ultrasound densitometry combined with FRAX algorithm. The structural and functional parameters of the heart and blood vessels were determined using the two-dimensional echocardiography and pulsed-wave Doppler imaging.
Results. It was established that in women with CAD there was a significant decrease in T- and Z-criteria and an increase in the 10-year risk of developing of osteoporosis fractures, depending on the severity of BMD loss. The presence of postmenopausal osteoporosis in women with coronary artery disease was associated with a significant increase in thickness of the intima-media complex of the right and left common carotid artery (by 14.94 % and 15.56 % respectively), LV PWd (by 9.26 %), and LV Myocardial stiffness index (by 40.00 %), decreased LV EF (by 8.77 %), development of the LV diastolic dysfunction by the type of the impaired relaxation (in 80.76 %), formation of predominantly concentric hypertrophy of LV (in 68.18% of cases) and an increase in the incidence of LV eccentric hypertrophy compared to patients with normal BMD (11.36 % vs. 4.17 %; χ2 = 4.267; df = 1; P < 0.05). In women with coronary artery disease and BMD abnormalities, the number of patients with heart valves calcification was significantly higher: 60.00 % in the group with osteopenia, 77.42 % in the group with osteoporosis in comparison with 28.58 % in the group with normal BMD; there was an increase in the incidence of calcinosis identification in two or more heart valves. The existence of a correlative dependence was established between T-and Z-criteria of the radial bone and LV EF (r = +0.42; P < 0.05), LV ESV (r = +0.61; P < 0.05), between Z-criteria of the radius, the 10-year risk of development of fractures of the radial bone and tibia and LAD (r = +0.43; P < 0.05; r = +0.50; P < 0.05 respectively), between the 10-year risk of the development of the tibial fractures and LVM (r = +0.58; P < 0.05).
Conclusions. Changes in the structural and functional parameters of the heart in women with coronary artery disease progress depending on the severity of BMD loss, which indicates the interrelationship of bone and cardiovascular remodeling.
References
de Villiers, T., & Tatarchuk, T. F. (2016) Natsionalnyi konsensus shchodo vedennia patsiientok u klimakterii [National consensus on the management of patients in menopause]. Reproductyvna endokrynolohia, 1(27), 8–25. [in Ukrainian]. doi: http://dx.doi.org/10.18370/2309-4117.2016.27.8-25
Davis, S. R., Lambrinoudaki, I., Lumsden, M., Mishra, G. D., Pal, L., Rees, M., et al. (2015) Menopause. Nature Reviews Disease Primers, 1, 15004. doi: 10.1038/nrdp.2015.4.
Mitchenko, O. I., & Illiushyna, H. Ya. (2016) Rannia menopauza yak spetsyfichnyi faktor sertsevo-sudynnoho ryzyku v zhinok [Early menopause as a specific risk factor for cardiovascular risk in women]. Ukrainskyi kardiolohichnyi zhurnal, 3, 85–90. [in Ukrainian].
Mitchenko, O. I., Mamedov, M. N., Kolesnik, T. V., Deev, A. D., Romanov, V. Yu., & Ilyushina, G. Y. (2015) Osoblyvosti poshyrenosti chynnykiv sertsevo-sudynnoho ryzyku v zhinok zalezhno vid naiavnosti menopauzy [Features of cardiovascular risk factors in women depending on menopause]. Ukrainskyi kardiolohichnyi zhurnal, 4, 96102. [in Ukrainian].
Pasieshvili, L. M. (2015) Osteoporoz bezmolvnyj kostnyj vor [Osteoporosis is silent bone “Thief”]. Skhidnoievropeiskyi zhurnal vnutrishnoi ta simeinoi medytsyny, 1, 16–24. [in Russian].
Golovach, I. Yu. (2018) Sovremennaya strategiya diagnostiki i dolgovremennogo lecheniya postmenopausal`nogo osteoporoza [Modern strategy of diagnostics and long-term treatment of postmenopausal osteoporosis]. Ukrainskyi revmatolohichnyi zhurnal, 2(72), 9–16. [in Russian].
Barna, O., Golovach, I., Pogrebnyak, O., Korost, Ya., Pekhenko, V., Alifer, O., & Lotushko, V. (2017) Otsinka stanu kistkovoi tkanyny za pokaznukamy UZ densytometrii u vikovomu aspekti (doslidzhennia SKELET) [Evaluation of the bone tissue state in terms of ultrasound densitometry in the age aspect (SCELET research)]. Liky Ukrainy, 8(214), 65–70. [in Ukrainian].
Bugrim, T. V. (2014) Suchasni pidkhody do diahnostyky osteoporozu ta ishemichnoi khvoroby serdtsia v zhinok u pisliamenopauzalnomy periodi v umovakh pervynnoi medyko-sanitarnoi dopomohy [Modern approaches to diagnostics of osteoporosis and ischemia in women after menopause under conditions of primary medical and sanitary aid]. Medychni perspektyvy, 19(1), 77–81. [in Ukrainian].
Nishkumay, O. I. (2016) Kaltsyfikatsiia sudyn, ateroskleroz i osteoporoz: chy ye vzaiemozviazok? [Calcification of blood vessels, atherosclerosis and osteoporosis: is there a relationship?]. Sertse i sudyny, 1, 107–112. [in Ukrainian].
Ahmadi, N., Mao, S. S., Hajsadeghi, F., Arnold, B., Kiramijyan, S., Gao, Y., et al. (2018) The relation of low levels of bone mineral density with coronary artery calcium and mortality. Osteoporos. Int., 29(7), 1609–1616. doi: 10.1007/s00198-018-4524-7
Malyuta, E. B., Raskina, T. A., Barbarash, O. L., Kokov, A. N., Masenko, V. L., & Voronkina, V. A. (2014) Vzaimosvyaz` osteopenicheskogo sindroma i porazheniya koronarnykh arterij u muzchin s ishemitcheskoj bolezn`yu serdca [Relationship between the osteopenic syndrome and coronary artery disease in male patients with ischemic heart disease]. Sovremennaya revmatologiya, 8(1), 18–22. [in Russian].
Zhang, H., Wang, L. J., Si, D. L., Wang, C., Yang, J. C., Jiang, P., et al. (2015) Correlation between osteocalcin‐positive endothelial progenitor cells and spotty calcification in patients with coronary artery disease. Clin. Exp. Pharmacol. Physiol., 42(7), 734–9. doi: 10.1111/1440-1681.12366
Mykhailovska, N. S., & Stetsiuk, I. O. (2018) The indicators of the bone tissue mineralization abnormalities in women with coronary artery disease in the post-menopausal period. Pathologia, 15, 2(43), 136–141. doi: 10.14739/2310-1237.2018.2.141408
Tsarenok, S. Yu. (2017) Strukturno-funkcional`nye izmeneniya miokarda u zhenshchin s osteoporozom v sochetanii s ishemicheskoj bolezn`yu serdca [Structural and functional changes of myocardium in women with osteoporosis in combination with ischemic heart disease]. Klinicist, 11(3–4), 50–58. doi: 10.17650/1818-8338-2017-11-3-4-50-58 [in Russian].
Wang, R.T., Li, X.S., Zhang, J. R., Sun, Y., Yu, K. J.,& Liu, T. (2016) Bone mineral density is associated with left ventricular diastolic function in women, Clinical Cardiology, 39(12), 709–714. doi: 10.1002/clc.22592
Sagalovsky, S., & Richter, T. (2016). Kal'cifikaciya sosudov i osteoporoz: ot ponimaniya edinstva kletochno-molekulyarnykh mekhanizmov k poisku molekul kak potencial'nykh mishenej terapii [Vascular calcification and osteoporosis: from understanding common cellular and molecular mechanisms to search molecules as potential therapeutic targets]. Ukrainskyi kardiolohichnyi zhurnal, 1, 81–92. [in Russian].
Tanna, N., Patel, K., Moore, A. E., Dulnoan, D., Edwards, S., & Hampson, G. (2017) The relationship between circulating adiponectin, leptin and vaspin with bone mineral density (BMD), arterial calcification and stiffness: a cross-sectional study in post-menopausal women. J. Endocrinol. Invest., 40(12), 1345–1353. doi: 10.1007/s40618-017-0711-1
Xu, R., Cheng, X.-C., Zhang, Y., Lai, H.-M., & Yang, H.-N. (2018) Association of Severity of Coronary Lesions with Bone Mineral Density in Postmenopausal Women. Arquivos Brasileiros de Cardiologia, 110(3), 211–216. doi: 10.5935/abc.20180035
Downloads
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (SeeThe Effect of Open Access).
