Ezgi Kalaycıoğlu1, Tayyar Gökdeniz2, Ahmet Çağrı Aykan3, Engin Hatem4, Mustafa Ozan Gürsoy5, Asım Ören6, Hüseyin Yaman6, Ayşe Gül Karadeniz7, Şükrü Çelik3. 1. Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey. Electronic address: ezgikalay@gmail.com. 2. Department of Cardiology, Kafkas University, Faculty of Medicine, Kars, Turkey. 3. Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey. 4. Department of Cardiology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey. 5. Department of Cardiology, Gaziemir Salih Nevvar İşgören State Hospital, İzmir, Turkey. 6. Department of Medical Biochemistry, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey. 7. Department of Radiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
Abstract
BACKGROUND: Recently, the role of osteoprotegerin (OPG) in the pathogenesis of heart failure through different mechanisms has received much attention. Subclinical changes in left ventricular (LV) function can be identified using quantification of myocardial strain, and global longitudinal strain (GLS) is a superior predictor of outcomes than ejection fraction. We hypothesized that increased OPG levels could predict subclinical LV systolic dysfunction in treated diabetic hypertensive patients with preserved LV ejection fraction. METHODS: The study was composed of 86 diabetic hypertensive and 30 nondiabetic hypertensive patients. All patients underwent echocardiography and venous blood samples were taken for determination of OPG. The relation between OPG levels and LV GLS was investigated using 2-dimensional speckle tracking echocardiography. RESULTS: Diabetic hypertensive patients had higher diastolic peak early/early diastolic tissue velocity and lower systolic tissue velocity, GLS, GLS rate systolic, and GLS rate early diastolic than nondiabetic hypertensive patients (P = 0.009, P = 0.049, P < 0.001, P = 0.004, and P < 0.001, respectively). Diabetic hypertensive patients were divided into 2 groups according to median GLS value (> 18.5 and ≤ 18.5). The patients with GLS ≤ 18.5 had higher diastolic blood pressure (mm Hg; P = 0.048), OPG (pmol/L; P < 0.001), and hemoglobin A1c (%; P = 0.042) values than those with GLS > 18.5. In multivariate logistic regression analysis, OPG was found to be an independent predictor of impaired GLS (P = 0.001). Receiver operating characteristic curve analysis revealed that OPG values of > 6.45 (pmol/L) identified the patients with GLS ≤ 18.5. CONCLUSIONS: Plasma OPG values could predict subclinical LV systolic dysfunction in diabetic hypertensive patients.
BACKGROUND: Recently, the role of osteoprotegerin (OPG) in the pathogenesis of heart failure through different mechanisms has received much attention. Subclinical changes in left ventricular (LV) function can be identified using quantification of myocardial strain, and global longitudinal strain (GLS) is a superior predictor of outcomes than ejection fraction. We hypothesized that increased OPG levels could predict subclinical LV systolic dysfunction in treated diabetic hypertensivepatients with preserved LV ejection fraction. METHODS: The study was composed of 86 diabetic hypertensive and 30 nondiabetic hypertensivepatients. All patients underwent echocardiography and venous blood samples were taken for determination of OPG. The relation between OPG levels and LV GLS was investigated using 2-dimensional speckle tracking echocardiography. RESULTS:Diabetic hypertensivepatients had higher diastolic peak early/early diastolic tissue velocity and lower systolic tissue velocity, GLS, GLS rate systolic, and GLS rate early diastolic than nondiabetic hypertensivepatients (P = 0.009, P = 0.049, P < 0.001, P = 0.004, and P < 0.001, respectively). Diabetic hypertensivepatients were divided into 2 groups according to median GLS value (> 18.5 and ≤ 18.5). The patients with GLS ≤ 18.5 had higher diastolic blood pressure (mm Hg; P = 0.048), OPG (pmol/L; P < 0.001), and hemoglobin A1c (%; P = 0.042) values than those with GLS > 18.5. In multivariate logistic regression analysis, OPG was found to be an independent predictor of impaired GLS (P = 0.001). Receiver operating characteristic curve analysis revealed that OPG values of > 6.45 (pmol/L) identified the patients with GLS ≤ 18.5. CONCLUSIONS: Plasma OPG values could predict subclinical LV systolic dysfunction in diabetic hypertensivepatients.
Authors: Turhan Turan; Ahmet Özderya; Sinan Şahin; Ali Hakan Konuş; Selim Kul; Ali Rıza Akyüz; Ezgi Kalaycıoğlu; Muhammet Raşit Sayın Journal: Int J Cardiovasc Imaging Date: 2021-08-13 Impact factor: 2.357