Objectives Our objective was to describe changes in bone mineral density (BMD), incidence of fractures and levels of bone remodeling markers in the first year post-heart transplant (postHTX).
Methods We included patients aged ≥18 years with heart transplant performed in our institution from 01.01.2013 to 31.07.2015, excluding those on antiresorptive or bone forming treatment and pregnant women. Before heart transplant (preHTX) and in the one year postHTX visit, the following data were registered: body mass index, risk factors for osteoporosis, biochemical parameters of bone metabolism, presence of osteopenia or osteoporosis in the densitometric analysis of lumbar spine and femoral neck, presence of fractures in the X-ray of the spine and echocardiographic left ventricular ejection fraction (LVEF).
Results All 17 patients (age 48±16 years, 12 male) included in the study were treated with calcineurin inhibitors and steroids (mean dose 15 mg/day). At the preTX visit, body mass index was 24,7±3,8 kg/m2, obesity was present in 4 patients, DM in 1, kidney stones in 3, excessive alcohol consumption in 1, and 11 patients were ex-smokers. Low BMD was present in 14/17 patients (82%) in the preTX visit: 12 osteopenia (8 men and 4 women) and 2 osteoporosis (1 man and 1 woman); and 15/17 patients (88%) in the one year postTX visit: 9 osteopenia (6 men and 3 women) and 6 osteoporosis (3 men and 3 women). One patient died before the first year postHTX visit. Twelve patients (80%) had a vitamin D blood level <20 ng/ml at the one year postHTX visit. A man presented a spinal fracture in the follow-up. Mean LVEF was 25±6% (preHTX) and 75±8% (postHTX).
Conclusions In this pilot study, 82% of heart transplant recipients had a low BMD preHTX and 88% at the one year postHTX visit. Moreover, 80% of patients had a vitamin D deficiency at the one year postHTX visit. Larger studies are required to fully evaluate this morbidity and describe clinical predictors.
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Disclosure of Interest None declared
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