title: Osteoprotegerin is associated with subclinical left ventricular systolic dysfunction in diabetic hypertensive patients: a speckle tracking study.
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.
authors.affiliation: Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey. Electronic address: ezgikalay@gmail.com.
authors.forename: Ezgi
authors.initials: E
authors.lastname: Kalaycıoğlu
authors.affiliation: Department of Cardiology, Kafkas University, Faculty of Medicine, Kars, Turkey.
authors.forename: Tayyar
authors.initials: T
authors.lastname: Gökdeniz
authors.affiliation: Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
authors.forename: Ahmet Çağrı
authors.initials: AÇ
authors.lastname: Aykan
authors.affiliation: Department of Cardiology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.
authors.forename: Engin
authors.initials: E
authors.lastname: Hatem
authors.affiliation: Department of Cardiology, Gaziemir Salih Nevvar İşgören State Hospital, İzmir, Turkey.
authors.forename: Mustafa Ozan
authors.initials: MO
authors.lastname: Gürsoy
authors.affiliation: Department of Medical Biochemistry, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey.
authors.forename: Asım
authors.initials: A
authors.lastname: Ören
authors.affiliation: Department of Medical Biochemistry, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey.
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Yaman
authors.affiliation: Department of Radiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
authors.forename: Ayşe Gül
authors.initials: AG
authors.lastname: Karadeniz
authors.affiliation: Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
authors.forename: Şükrü
authors.initials: Ş
authors.lastname: Çelik
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000503:physiopathology*; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D053244:Osteoprotegerin / Q000097:blood*; D011379:Prognosis; D012189:Retrospective Studies; D013318:Stroke Volume; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000000981:diagnostic imaging / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D053244:Osteoprotegerin