Avci Anil, Elnur Alizade, Göksel Acar, Serdar Fidan, Servet Izci, Atilla Koyuncu, Mustafa Tabakcı Mehmet, Cuneyt Toprak, Yeliz Guler, Mustafa Bulut, Metin Esen Ali
Cardiology Deparment, Kartal Koşuyolu Heart Research and Training Hospital, Istanbul, Turkey.
Echocardiography. 2014 Oct;31(9):1031-5. doi: 10.1111/echo.12534. Epub 2014 Feb 14.
The role of inflammation in fibrotic and calcific processes of atherosclerosis and aortic stenosis (AS) is similar. Furthermore, a relationship between systemic inflammation and heart failure has been well demonstrated. Recently, neutrophil/lymphocyte ratio (NLR) has been proposed as a predictive marker of systemic inflammation. We investigated the association of NLR with the severity of calcific AS and left ventricular (LV) systolic dysfunction in patients with severe calcific AS.
A total of 96 patients with calcific AS were included in this retrospective study from 2011 to 2013. The severity of AS was graded according to the transaortic mean pressure gradient. The patients were divided into 3 groups as mild-to-moderate AS, severe AS with normal left ventricular ejection fraction (LVEF), and severe AS with reduced LVEF (mean gradient >40 mmHg and LVEF <50%).
Neutrophil/lymphocyte ratio was significantly higher in severe calcific AS with reduced LVEF group than the other 2 groups (3.94 ± 0.88, P < 0.001). In addition, NLR was higher in severe AS with normal LVEF group than mild-to-moderate AS group (2.69 ± 1.00 vs. 2.05 ± 0.64, P = 0.008). There was a statistically significant correlation between NLR and both transaortic mean pressure gradient and aortic valve peak velocity in patients with mild-to-severe AS with normal LVEF (n = 81; r = 0.369, P < 0.001; r = 0.290, P = 0.004; respectively).
Increased NLR is related to the severity of calcific AS and LV systolic dysfunction in patients with severe calcific AS.
炎症在动脉粥样硬化和主动脉瓣狭窄（AS）的纤维化及钙化过程中所起的作用相似。此外，全身炎症与心力衰竭之间的关系已得到充分证实。最近，中性粒细胞/淋巴细胞比值（NLR）被提议作为全身炎症的预测标志物。我们研究了NLR与重度钙化性AS患者钙化性AS的严重程度及左心室（LV）收缩功能障碍之间的关联。
本回顾性研究纳入了2011年至2013年期间的96例钙化性AS患者。根据经主动脉平均压力梯度对AS的严重程度进行分级。患者被分为3组，即轻度至中度AS组、左心室射血分数（LVEF）正常的重度AS组和LVEF降低的重度AS组（平均梯度>40 mmHg且LVEF<50%）。
LVEF降低的重度钙化性AS组的中性粒细胞/淋巴细胞比值显著高于其他两组（3.94±0.88，P<0.001）。此外，LVEF正常的重度AS组的NLR高于轻度至中度AS组（2.69±1.00对2.05±0.64，P=0.008）。在LVEF正常的轻度至重度AS患者中（n=81；r=0.369，P<0.001；r=0.290，P=0.004），NLR与经主动脉平均压力梯度及主动脉瓣峰值速度之间存在统计学显著相关性。
NLR升高与重度钙化性AS患者钙化性AS的严重程度及LV收缩功能障碍相关。
