title: Global Longitudinal Strain and Strain Rate in Type Two Diabetes Patients with Chronic Heart Failure: Relevance to Osteoprotegerin.
abstract: Biomechanical stress and inflammatory biomarkers relate to global contractility dysfunction; however, adding these biomarkers into a risk model constructed on clinical data does not improve its prediction value in chronic heart failure (CHF).
  
  
  
  The aim of this study was to evaluate whether biomarkers predict declining of left ventricular global contractility function in diabetic patients with ischemia-induced CHF.
  
  
  
  The study retrospectively evolved 54 diabetic patients who had systolic or diastolic ischemia-induced CHF that was defined as left-ventricular ejection fraction (LVEF) ≤45% or 46-55% respectively assessed by quantitative echocardiography and other conventional criteria according to current clinical guidelines. Two-dimensional transthoracic echocardiography and tissue Doppler imaging were performed according to a conventional method. Radial, longitudinal, and circumferential strain and strain rate values were obtained by speckle-tracking Imaging analysis of both LV short axis and long axis views. Serum adiponectin, NT-pro brain natriuretic peptide (BNP), osteoprotegerin, and hs- C-reactive protein (CRP) were determined at baseline by ELISA.
  
  
  
  We found lower global longitudinal strain and strain rate in diabetic patients with LVEF <45% than these in diabetic patients that did not have LVEF (Р=0.001 for all cases). Multivariate logistic regression analysis showed that NT-proBNP (r=0.432; P=0.001 and r=0.402; P=0.001, respectively), osteoprotegerin (r=0.422; P=0.001 and r=0.401; P=0.001, respectively), hs-CRP (r=0.408; P=0.001 and r=0.404; P=0.001, respectively) were independently inversely associated with global longitudinal strain and strain rate in CHF patients.
  
  
  
  We suggest that osteoprotegerin may be useful in improving the NT-proBNP based model as predictor of decreased global contractility function in diabetic patients with CHF.
authors.affiliation: Laboratory of Structural Biology and Proteomics, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic
authors.forename: Peter
authors.initials: P
authors.lastname: Kruzliak
authors.affiliation: Department of Internal Medicine, State Medical University, Zaporozhye, Ukraine
authors.forename: Alexander
authors.initials: A
authors.lastname: Berezin
authors.affiliation: Department of Clinical Pharmacology, State Medical University, Zaporozhye, Ukraine
authors.forename: Alexander
authors.initials: A
authors.lastname: Kremzer
authors.affiliation: Department of Clinical Pharmacology, State Medical University, Zaporozhye, Ukraine
authors.forename: Tatyana
authors.initials: T
authors.lastname: Samura
authors.affiliation: Benimed Ltd
authors.forename: Roman
authors.initials: R
authors.lastname: Benacka
authors.affiliation: Department of Functional Sciences, Victor Babes University of Medicine and Pharmacy, Timișoara, Romania
authors.forename: Ioana
authors.initials: I
authors.lastname: Mozos
authors.affiliation: Department of Clinical Medicine, Education Division, Trinity College, University of Dublin, Dublin, Ireland
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Egom
authors.affiliation: Central University Hospital of Asturia, University of Oviedo, Oviedo, Spain
authors.forename: Luis
authors.initials: L
authors.lastname: Rodrigo
mesh_terms: D015415:Biomarkers / Q000097:blood; D003920:Diabetes Mellitus / Q000097:blood* / Q000503:physiopathology*; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D053244:Osteoprotegerin / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood; D012189:Retrospective Studies; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology*
chemical_list: D015415:Biomarkers; D053244:Osteoprotegerin; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain