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.

中文翻译：

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高血压和糖尿病患者的血清骨保护素水平与亚临床左心房机械功能独立相关。

目标

先前的研究表明，亚临床异常左心房（LA）功能可以在室扩大之前很久就可以通过LA斑点追踪评估来诊断。骨保护素（OPG）是肿瘤坏死因子（TNF）受体超家族的成员，最近被发现是心血管不良结果的指标，也是新发房颤的危险因素。作者假设OPG值可预测高血压（HT）和糖尿病（DM）患者的二维斑点追踪超声心动图（2D-STE）评估的LA机械功能障碍和LA重塑。

方法

进行了一项单中心研究，其中包括就诊于作者门诊的连续患者。入组患者需要接受HT和DM治疗至少1年。

结果

该研究包括80名患者（平均年龄57.5±8.3岁）。LA损伤组的患者年龄较大（p  = 0.035），低密度脂蛋白（LDL）胆固醇（mg / dl）较低（p  = 0.021），OPG（pmol / l）较高（p  = 0.004）正常LA应变组的患者。单因素逻辑回归分析表明，年龄（p  = 0.039），LDL胆固醇（mg / dl）（p  = 0.025）和OPG（pmol / l）（p  = 0.008）值与LA菌株受损有关。向后多元Logistic回归分析显示，LDL胆固醇（mg / dl）（OR：0.982，CI 95％0.964–0.999，p  = 0.049）和OPG（pmol / l）（OR：1.438，CI 95％1.043–1.983，p  = 0.027）与LA应变受损独立相关。

结论

在高血压和糖尿病患者中，较高的OPG值与2D-STE评估的LA功能受损有关。在此高危患者组中，血清OPG可用作LA机械功能障碍的风险预测指标。