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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.