Journal of Research and Development
Open Access

Abstract

Circulating Osteoprotegerin as Predictor of Global Systolic Dysfunction in Type Two Diabetes Patients with Chronic Heart Failure

Berezin AE, Kremzer AA, Samura TA

Background: 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).

Objectives: The aim of this study was to evaluate the interrelationship between left ventricular global contractility function and circulating biomarkers in diabetic patients with ischemia-induced CHF.

Patients and methods: The study retrospectively selected 54 T2DM subjects from 388 patients who had systolic or diastolic ischemia-induced CHF, that was defined as left-ventricular ejection fraction ≤ 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. Serum adiponectin, NT-proBNP, osteoprotegerin, and hs-CRP were determined at baseline by ELISA.

Results: We found lower global longitudinal strain and strain rate in T2DM patients with LVEF <45% when compared with those who did not have (?=0.001 for all cases). Multivariate logistic regression reported that NTproBNP (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 global longitudinal strain rate in CHF patients.

Conclusion: We suggest that osteoprotegerin may be useful for improvement of NT-proBNP based model as predictor of decreased global contractility function in T2DM patients with CHF.