Serum osteoprotegerin level is independently related to subclinical left atrial mechanical function in patients with hypertension and diabetes

• Published in: Herz 2021-06, Vol.46 (3), p.277-284
• Main Authors: Kalaycıoğlu, Ezgi, Çetin, Mustafa, Çinier, Göksel, Kırış, Tuncay, Gökdeniz, Tayyar, Özyıldız, Ali Gökhan, Durmuş, İsmet
• Format: Article
• Language: English
• Subjects: Aged; Atrial Function, Left; Atrial Remodeling; Biomedical materials; Cardiology; Cardiovascular diseases; Cholesterol; Diabetes; Diabetes mellitus; Diabetes Mellitus - epidemiology; Echocardiography; Enlargement; Fibrillation; Health risks; Heart Atria - diagnostic imaging; Humans; Hypertension; Internal Medicine; Low density lipoprotein; Mechanical properties; Medicine; Medicine & Public Health; Middle Aged; Original Articles; Osteoprotegerin; Regression analysis; Risk analysis; Risk factors; Risk groups; Tracking; Tumor necrosis factor; Tumor necrosis factor-TNF
• ISSN: 0340-9937; 1615-6692
• DOI: 10.1007/s00059-020-04939-7

Objectives Previous studies showed that subclinical abnormal left atrial (LA) function could be diagnosed with LA speckle tracking evaluation long before chamber enlargement. Osteoprotegerin (OPG) is a member of the tumor necrosis factor (TNF) receptor superfamily and was recently found to be an indicator for adverse cardiovascular outcomes and a risk factor for new onset atrial fibrillation. The authors hypothesized that OPG values could predict LA mechanical dysfunction and LA remodeling assessed by two-dimensional speckle tracking echocardiography (2D-STE) in patients with hypertension (HT) and diabetes mellitus (DM). Methods A single center study was conducted including consecutive patients presenting to the authors’ outpatient clinic. Enrolled patients needed to have been treated for HT and DM for at least 1 year. Results The study included 80 patients (mean age, 57.5 ± 8.3 years). Patients in the impaired LA strain group were older ( p  = 0.035), had lower low density lipoprotein (LDL) cholesterol (mg/dl) ( p  = 0.021), and higher OPG (pmol/l) ( p  = 0.004) values than patients in the normal LA strain group. Univariate logistic regression analysis demonstrated that age ( p  = 0.039), LDL cholesterol (mg/dl) ( p  = 0.025), and OPG (pmol/l) ( p  = 0.008) values were associated with impaired LA strain. Backward multivariate logistic regression analysis showed that LDL cholesterol (mg/dl) (OR: 0.982, CI 95% 0.964–0.999, p  = 0.049) and OPG (pmol/l) (OR: 1.438, CI 95% 1.043–1.983, p  = 0.027) were independently associated with impaired LA strain. Conclusion In hypertensive and diabetic patients, higher OPG values were associated with impaired LA function assessed by 2D-STE. In this high-risk patient group, serum OPG can be used as a risk predictor for LA mechanical dysfunction.