Neutrophil-to-lymphocyte ratio is increased in patients with rheumatic mitral valve stenosis?

ALSANCAK, Yakup; GÖKALP, GÖKHAN; Akboga, Mehmet Kadri; ABACI, ADNAN; YAYLA, ÇAĞRI; AKYEL, Ahmet; NURKOÇ, Serdar; ŞAHİNARSLAN, Asife

Neutrophil-to-lymphocyte ratio is increased in patients with rheumatic mitral valve stenosis?

Mehmet Kadri AKBOĞA, (Ministry of Health Etimesgut State Hospital)

Ahmet AKYEL, (Department of Cardiology, Dışkapı Yıldırım Beyazıt Education and Research Hospital; Ankara-Turkey)

Asife ŞAHİNARSLAN, (Department of Cardiology, Faculty of Medicine, Gazi University; Ankara-Turkey)

Çağrı YAYLA, (Department of Cardiology, Faculty of Medicine, Gazi University; Ankara-Turkey)

Yakup ALSANCAK, (Department of Cardiology, Faculty of Medicine, Gazi University; Ankara-Turkey)

Gökhan GÖKALP, (Department of Cardiology, Faculty of Medicine, Gazi University; Ankara-Turkey)

Serdar NURKOÇ, (Department of Cardiology, Faculty of Medicine, Gazi University; Ankara-Turkey)

Adnan ABACI (Department of Cardiology, Faculty of Medicine, Gazi University; Ankara-Turkey)

The Anatolian Journal of Cardiology

3 0

Yıl: 2015 Cilt: 15 Sayı: 5 Sayfa Aralığı: 380 - 384 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Neutrophil-to-lymphocyte ratio is increased in patients with rheumatic mitral valve stenosis?

Öz:

Amaç: Romatizmal kalp kapak hastalığının patofizyolojisinde sistemik ve kronik enflamatuvar sürecin rolü iyi bilinmektedir. Nötrofilin lenfosite oranının (NLO) sistemik enflamasyonun bir göstergesi olduğu gösterilmiştir. Biz bu çalışmamızda enflamasyon belirteci olan NLO ile romatizmal mitral kapak hastalığı (RMKH) arasındaki ilişkiyi incelemeyi amaçladık. Yöntemler: Ocak 2008-Mart 2013 tarihleri arasında transtorasik ekokardiyografi yapılan hastalar arasından RMKH olan 314 hasta retrospektif olarak çalışmaya dahil edildi. Kontrol grubu, çalışma döneminde transtorasik ekokardiyografi yapılan 57 sağlıklı bireyi içermektedir. Temel özellikler ve NLO iki grup arasında karşılaştırıldı. RMKH'nın bağımsız öngördürücüleri lojistik regresyon analizi ile tespit edildi. Bulgular: Temel özellikler gruplar arasında benzerdi. NLO, RMKH olan hastalarda anlamlı olarak daha yüksekti [2,9 (0,6-13,0)'e karşı 2,1 (0,7-5,8), p<0,001]. Ayrıca, C-reaktif protein (CRP) de RMKH grubunda daha yüksekti [5,99 (0,3-23,7)'e karşı 2,98 (0,6-6,3), p=0,001]. Regresyon analizinde, NLO (OR: 2,24, p=0,04), CRP (OR: 1,34, p=0,03) ve sol atriyal boyut (OR: 1,21, p=0,001) RMKH'nın bağımsız öngördürücüleriydi. Korelasyon analizinde NLO ile CRP arasında anlamlı pozitif korelasyon vardı (r=0,43, p<0,001). Sonuç: NLO'yu RMKH'de anlamlı şekilde artmış bulduk. Üstelik NLO bizim çalışma popülasyonumuzda RMKH varlığının bağımsız bir öngördürücüsü idi. Bu bulgulara göre NLO, RMKH'nın bir öngördürücüsü olarak kullanılabilir. Ucuz ve kolayca ulaşılabilen bir yöntem olduğundan günlük klinik uygulamada kolayca kullanılabilir. Ayrıca artmış NLO, RMKH hastalarında devam eden kronik inflamasyonun bir işareti olabilir.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Romatizmal mitral kapak hastalarında nötrofilin lenfosite oranı artmıştır

Öz:

Objective: The role of systemic and chronic inflammatory processes in the pathophysiology of rheumatic heart valve disease is well known. The neutrophil-to-lymphocyte ratio (NLR) was shown to be an indicator of systemic inflammation. In this study, we aimed to investigate relationship between NLR as a marker of systemic inflammation and rheumatic mitral valve stenosis (RMVS).Methods: This is a retrospective study. Among patients who underwent transthoracic echocardiography between January 2008-March 2013, 314 patients with RMVS were included retrospectively in the study. The control group included 57 healthy persons who underwent transthoracic echocardiography during the study period. Basal characteristics and NLR were compared between the two groups. Independent predictors of RMVS were determined by logistic regression analysis.Results: Basal characteristics were similar among the groups (age, 50.2±14.2 vs. 49.2±13.0, p=0.60). The NLR was significantly higher in patients with RMVS [2.9 (0.6-13.0) vs. 2.1 (0.7-5.8), p<0.001]. Besides, C-reactive protein (CRP) was also higher in the RMVS group [5.99 (0.3-23.7) vs. 2.98 (0.6-6.3), p=0.001]. In the regression analysis, NLR (OR: 2.24, p=0.04), CRP (OR: 1.34, p=0.03), and left atrial diameter (OR: 1.21, p=0.001) were independent predictors of RMVS. In the correlation analysis, there was a significant positive correlation between NLR and CRP (r=0.43, p<0.001).Conclusion: We found that NLR was significantly increased in RMVS. Furthermore, NLR was an independent predictor of the presence of RMVS in our study population. According to these findings, NLR can be used as a predictor of RMVS. Since it is an easily available and cheap method, it can easily be used in daily clinical practice. Increased NLR can also be a sign of ongoing chronic inflammation in patients with RMVS

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Filgner CR, Reichenbach DD, Otto CM. Pathology and etiology of valvular heart disease. In: Otto CM, editor. Valvular Heart Disease. 2nd ed. Philadelphia: WB Saunders; 2004.p.30-3.
2. Marcus RH, Sareli P, Pocock WA, Barlow JB. The spectrum of severe rheumatic mitral valve disease in a developing country: Correlations among clinical presentation, surgical pathologic findings, and hemodynamic sequelae. Ann Intern Med 1994; 120: 177-83. [CrossRef]
3. Olsson M, Thyberg J, Nilsson J. Presence of oxidized low density lipoprotein in nonrheumatic stenotic aortic valves. Arterioscler Thromb Vasc Biol 1999; 19: 1218-22. [CrossRef]
4. Gölbaşı Z, Uçar O, Keleş T, Şahin A, Cağlı K, Çamsarı A, et al. Increased levels of high sensitive C-reactive protein in patients with chronic rheumatic valve disease: evidence of ongoing inflammation. Eur J Heart Fail 2002; 4: 593-5. [CrossRef]
5. Yetkin E, Erbay AR, İleri M, Turhan H, Balcı M, Çehreli S, et al. Levels of circulating adhesion molecules in rheumatic mitral stenosis. Am J Cardiol 2001; 88: 1209-11. [CrossRef]
6. Gurm HS, Bhatt DL, Lincoff AM, Tcheng JE, Kereiakes DJ, Kleiman NS, et al. Impact of preprocedural white blood cell count on long term mortality after percutaneous coronary intervention: insights from the EPIC, EPILOG, and EPISTENT trials. Heart 2003; 89: 1200-4. [CrossRef]
7. Kaya MG, Akpek M, Elçik D, Kalay N, Yarlioğlues M, Koç F, et al. Relation of left atrial spontaneous echocardiographic contrast in patients with mitral stenosis to inflammatory markers. Am J Cardiol 2012; 109: 851-5. [CrossRef]
8. Gillum RF, Mussolino ME, Madans JH. Counts of neutrophils, lymphocytes, and monocytes, cause-specific mortality and coronary heart disease: the NHANES-I epidemiologic follow-up study. Ann Epidemiol 2005; 15: 266-71. [CrossRef]
9. Margolis KL, Manson JE, Greenland P, Rodabough RJ, Bray PF, Safford M, et al. Leukocyte count as a predictor of cardiovascular events and mortality in postmenopausal women: the Women's Health Initiative Observational Study. Arch Intern Med 2005; 165: 500-8. [CrossRef]
10. Horne BD, Anderson JL, John JM, Weaver A, Bair TL, Jensen KR, et al. Which white blood cell subtypes predict increased cardiovascular risk? J Am Coll Cardiol 2005; 45: 1638-43. [CrossRef]
11. Gibson PH, Cuthbertson BH, Croal BL, Rae D, El-Shafei H, Gibson G, et al. Usefulness of neutrophil/lymphocyte ratio as predictor of new-onset atrial fibrillation after coronary artery bypass grafting. Am J Cardiol 2010; 105: 186-91. [CrossRef]
12. Baumgartner H, Hung J, Bermejo J, Chambers JB, Evangelista A, Griffin BP, et al. Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. Eur J Echocardiogr 2009; 10: 1-25. [CrossRef]
13. Carapetis JR, McDonald M, Wilson NJ. Acute rheumatic fever. Lancet 2005; 366: 155-68. [CrossRef]
14. Guilherme L, Cunha-Neto E, Coelho V, Snitcowsky R, Pomerantzeff PM, Assis RV, et al. Human heart-infiltrating T-cell clones from rheumatic heart disease patients recognize both streptococcal and cardiac proteins. Circulation 1995; 92: 415-20. [CrossRef]
15. Stollerman GH. Rheumatologic streptococci and autoimmunity. Clin Immunol Immunopathol 1991; 61: 131-42. [CrossRef]
16. Alyan O, Metin F, Kaçmaz F, Özdemir O, Maden O, Topaloğlu S, et al. High levels of high sensitivity C-reactive protein predict the progression of chronic rheumatic mitral stenosis. J Thromb Thrombolysis 2009; 28: 63-9. [CrossRef]
17. Chiu-Braga YY, Hayashi SY, Schafranski M, Messias-Reason IJ. Further evidence of inflammation in chronic rheumatic valve disease (CRVD): high levels of advanced oxidation protein products (AOPP) and high sensitive C-reactive protein. Int J Cardiol 2006; 109: 275-6. [CrossRef]
18. Zahorec R. Ratio of neutrophil to lymphocyte counts-rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy 2001; 102: 5-14.
19. Doğan M, Akyel A, Çimen T, Öksüz F, Çelik IE, Aytürk M, et al. Relationship between neutrophil-to-lymphocyte ratio and saphenous vein graft disease in patients with coronary bypass. Clin Appl Thromb Hemost 2013 May 7 [Epub ahead of print].
20. Öztürk S, Erdem A, Özlü MF, Ayhan S, Erdem K, Özyaşar M, et al. Assessment of the neutrophil to lymphocyte ratio in young patients with acute coronary syndromes. Turk Kardiyol Dern Ars 2013; 41: 284-9. [CrossRef]
21. Papa A, Emdin M, Passino C, Michelassi C, Battaglia D, Cocci F. Predictive value of elevated neutrophil-lymphocyte ratio on cardiac mortality in patients with stable coronary artery disease. Clin Chim Acta 2008; 395: 27-31. [CrossRef]
22. Sönmez O, Ertaş G, Bacaksız A, Taşal A, Erdoğan E, Asoğlu E, et al. Relation of neutrophil-to-lymphocyte ratio with the presence and complexity of coronary artery disease: an observational study. Anadolu Kardiyol Derg 2013; 13: 662-7.
23. Duffy BK, Gurm HS, Rajagopal V, Gupta R, Ellis SG, Bhatt DL. Usefulness of an elevated neutrophil to lymphocyte ratio in predicting long-term mortality after percutaneous coronary intervention. Am J Cardiol 2006; 97: 993-6. [CrossRef]
24. Turak O, Özcan F, İşleyen A, Başar FN, Gül M, Yılmaz S, et al. Usefulness of neutrophil-to-lymphocyte ratio to predict in-hospital outcomes in infective endocarditis. Can J Cardiol 2013; 12: 1672-8. [CrossRef]
25. Onsrud M, Thorsby E. Influence of in vivo hydrocortisone on some human blood lymphocyte subpopulations. I. Effect on natural killer cell activity. Scand J Immunol 1981; 13: 573-9. [CrossRef]
26. Hotchkiss RS, Karl IE. The pathophysiology and treatment of sepsis. N Engl J Med 2003; 348: 138-50. [CrossRef]

APA	Akboga M, AKYEL A, ŞAHİNARSLAN A, YAYLA Ç, ALSANCAK Y, GÖKALP G, NURKOÇ S, ABACI A (2015). Neutrophil-to-lymphocyte ratio is increased in patients with rheumatic mitral valve stenosis?. , 380 - 384.
Chicago	Akboga Mehmet Kadri,AKYEL Ahmet,ŞAHİNARSLAN Asife,YAYLA ÇAĞRI,ALSANCAK Yakup,GÖKALP GÖKHAN,NURKOÇ Serdar,ABACI ADNAN Neutrophil-to-lymphocyte ratio is increased in patients with rheumatic mitral valve stenosis?. (2015): 380 - 384.
MLA	Akboga Mehmet Kadri,AKYEL Ahmet,ŞAHİNARSLAN Asife,YAYLA ÇAĞRI,ALSANCAK Yakup,GÖKALP GÖKHAN,NURKOÇ Serdar,ABACI ADNAN Neutrophil-to-lymphocyte ratio is increased in patients with rheumatic mitral valve stenosis?. , 2015, ss.380 - 384.
AMA	Akboga M,AKYEL A,ŞAHİNARSLAN A,YAYLA Ç,ALSANCAK Y,GÖKALP G,NURKOÇ S,ABACI A Neutrophil-to-lymphocyte ratio is increased in patients with rheumatic mitral valve stenosis?. . 2015; 380 - 384.
Vancouver	Akboga M,AKYEL A,ŞAHİNARSLAN A,YAYLA Ç,ALSANCAK Y,GÖKALP G,NURKOÇ S,ABACI A Neutrophil-to-lymphocyte ratio is increased in patients with rheumatic mitral valve stenosis?. . 2015; 380 - 384.
IEEE	Akboga M,AKYEL A,ŞAHİNARSLAN A,YAYLA Ç,ALSANCAK Y,GÖKALP G,NURKOÇ S,ABACI A "Neutrophil-to-lymphocyte ratio is increased in patients with rheumatic mitral valve stenosis?." , ss.380 - 384, 2015.
ISNAD	Akboga, Mehmet Kadri vd. "Neutrophil-to-lymphocyte ratio is increased in patients with rheumatic mitral valve stenosis?". (2015), 380-384.

APA	Akboga M, AKYEL A, ŞAHİNARSLAN A, YAYLA Ç, ALSANCAK Y, GÖKALP G, NURKOÇ S, ABACI A (2015). Neutrophil-to-lymphocyte ratio is increased in patients with rheumatic mitral valve stenosis?. The Anatolian Journal of Cardiology, 15(5), 380 - 384.
Chicago	Akboga Mehmet Kadri,AKYEL Ahmet,ŞAHİNARSLAN Asife,YAYLA ÇAĞRI,ALSANCAK Yakup,GÖKALP GÖKHAN,NURKOÇ Serdar,ABACI ADNAN Neutrophil-to-lymphocyte ratio is increased in patients with rheumatic mitral valve stenosis?. The Anatolian Journal of Cardiology 15, no.5 (2015): 380 - 384.
MLA	Akboga Mehmet Kadri,AKYEL Ahmet,ŞAHİNARSLAN Asife,YAYLA ÇAĞRI,ALSANCAK Yakup,GÖKALP GÖKHAN,NURKOÇ Serdar,ABACI ADNAN Neutrophil-to-lymphocyte ratio is increased in patients with rheumatic mitral valve stenosis?. The Anatolian Journal of Cardiology, vol.15, no.5, 2015, ss.380 - 384.
AMA	Akboga M,AKYEL A,ŞAHİNARSLAN A,YAYLA Ç,ALSANCAK Y,GÖKALP G,NURKOÇ S,ABACI A Neutrophil-to-lymphocyte ratio is increased in patients with rheumatic mitral valve stenosis?. The Anatolian Journal of Cardiology. 2015; 15(5): 380 - 384.
Vancouver	Akboga M,AKYEL A,ŞAHİNARSLAN A,YAYLA Ç,ALSANCAK Y,GÖKALP G,NURKOÇ S,ABACI A Neutrophil-to-lymphocyte ratio is increased in patients with rheumatic mitral valve stenosis?. The Anatolian Journal of Cardiology. 2015; 15(5): 380 - 384.
IEEE	Akboga M,AKYEL A,ŞAHİNARSLAN A,YAYLA Ç,ALSANCAK Y,GÖKALP G,NURKOÇ S,ABACI A "Neutrophil-to-lymphocyte ratio is increased in patients with rheumatic mitral valve stenosis?." The Anatolian Journal of Cardiology, 15, ss.380 - 384, 2015.
ISNAD	Akboga, Mehmet Kadri vd. "Neutrophil-to-lymphocyte ratio is increased in patients with rheumatic mitral valve stenosis?". The Anatolian Journal of Cardiology 15/5 (2015), 380-384.