The relationship between serum osteoprotegerin levels and right atrial and ventricular speckle-tracking measurements in essential hypertension patients with normal left ventricular systolic function.

Abstract

Objective: We planned to reveal the relationship between OPG (osteoprotegerin) level and right heart function in hypertensive patients with normal ejection fraction, using strain analysis, which is a sensitive method in demonstrating subclinical dysfunction.

Methods: Between February and June 2018, 625 consecutive patients with a diagnosis of hypertension who applied to the cardiology out-patient clinic of our hospital were evaluated for our study and 175 eligible patients were included. The patients were divided into two groups according to their OPG level. Strain analysis was performed in the echocardiographic evaluation.

Results: The mean OPG value was 6.33 ± 1.87 pg/l. There were 93 patients (age 51.1 ± 8.5 years) in the low OPG group and 82 patients (age 54.6 ± 10.4 years) in the high OPG group. A significant difference was found between the two groups with regard to age (p = 0.016), statin use (p = 0.026), C-reactive protein level (p = 0.048), office systolic blood pressure (SBP) (p = 0.001) and office diastolic blood pressure (DBP) (p = 0.001). A significant difference was found between values of strain during reservoir phase (RASr) (p = 0.01), strain during conduit phase (RAScd) (p < 0.001) and peak strain rate during reservoir phase (pRASRcd) (p = 0.044). In multivariate regression analysis, age (OR: 1.162, 95% CI: 1.064-1.269, p = 0.001), office DBP (OR: 1.089, 95% CI: 1.020-1.161, p = 0.011) and RAScd (OR: 0.890, 95% CI: 0.815-0.972, p < 0.010) were found to be independent predictors of high OPG.

Conclusions: In our study, we found high OPG level was inversely correlated with right atrial strain values and linearly associated with high blood pressure. In order to take advantage of the negative indicators of high OPG, positive results can be obtained in strain values of the right heart by indirectly reducing the afterload of the right heart. This can be done by reducing high systemic blood pressure and providing tight blood pressure control.