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Global Longitudinal Strain and Strain Rate in Type Two Diabetes Patients with Chronic Heart Failure: Relevance to
Peter Kruzliak1, Alexander Berezin2, Alexander Kremzer3
1Laboratory of Structural Biology and Proteomics, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic
Insights
Biomarkers like osteoprotegerin may help predict declining heart function in diabetic patients with chronic heart failure (CHF). Adding osteoprotegerin to NT-proBNP models could improve predictions of reduced global contractility.
Area of Science:
- Cardiology
- Biomedical Engineering
- Diabetology
Background:
- Biomechanical stress and inflammatory biomarkers are linked to global contractility dysfunction in chronic heart failure (CHF).
- Existing risk models using clinical data and biomarkers do not significantly improve prediction accuracy for CHF.
- Diabetic patients with ischemia-induced CHF represent a vulnerable population requiring better predictive tools.
Purpose of the Study:
- To assess if specific biomarkers can predict the decline in left ventricular global contractility function.
- To investigate predictive capabilities in diabetic patients experiencing CHF induced by ischemia.
- To evaluate the role of serum biomarkers in conjunction with echocardiographic measures of contractility.
Main Methods:
- Retrospective analysis of 54 diabetic patients with systolic or diastolic ischemia-induced CHF.
- Echocardiography and tissue Doppler imaging assessed left-ventricular ejection fraction (LVEF), global longitudinal, radial, and circumferential strain/strain rate.
- Serum levels of adiponectin, NT-pro brain natriuretic peptide (BNP), osteoprotegerin, and hs-C-reactive protein (CRP) were measured via ELISA.
Main Results:
- Diabetic patients with LVEF <45% exhibited significantly lower global longitudinal strain and strain rate.
- Multivariate logistic regression revealed independent inverse associations between NT-proBNP, osteoprotegerin, hs-CRP, and global longitudinal strain/strain rate.
- These biomarkers were significant predictors of reduced contractility in CHF patients.
Conclusions:
- Osteoprotegerin may enhance predictive models for decreased global contractility function in diabetic CHF patients.
- The NT-proBNP based model could be improved by incorporating osteoprotegerin.
- These findings highlight potential biomarkers for monitoring cardiac function in this specific patient group.
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).
Aim:
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.
Patients And Methods:
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.
Results:
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.
Conclusion:
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.
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