Cakıcı Musa, Cetin Mustafa, Doğan Adnan, Oylumlu Muhammed, Aktürk Erdal, Polat Mustafa, Suner Arif, Abuş Sabri
Department of Cardiology, Adiyaman University Faculty of Medicine, Adiyaman, Turkey.
Department of Cardiology, Dumlipinar University Faculty of Medicine, Adiyaman, Turkey.
Turk Kardiyol Dern Ars. 2014 Oct;42(7):612-20. doi: 10.5543/tkda.2014.16363.
We aimed to assess the relationship between neutrophil to lymphocyte ratio (N/L ratio) and functional capacity (FC) of patients with compensated heart failure (CHF).
A total of 94 consecutive CHF patients and age-gender matched 70 subjects with normal echocardiographic examination were enrolled. Peripheral venous blood samples were drawn before echocardiography examination and treadmill test in all study population. The treadmill test based on modified Bruce protocol was used to determine the functional status of CHF patients. Poor FC was defined as <5 metabolic equivalant (MET) in the exercise test. Afterwards, patients with CHF were divided into two groups with respect to the top and bottom 3 of the N/L ratio.
FC (3.2 ± 2.05 MET vs. 6.1 ± 2.04 MET, p<0.001), ejection fraction (%31.5 ± 7.64 vs. %34.8 ± 6.82, p=0.028) were found to be lower and N-terminal pro-brain natriuretic peptide (NT-proBNP) level (3360 ± 2742 pg/dl vs. 1613 ± 1334 pg/dl, p<0.001) pulmonary artery pressure (46.3 ± 11.50 mmHg vs. 41.5 ± 9.45 mmHg, p=0.049), left atrial diameters (4.6 ± 0.52 cm vs. 4.3 ± 0.43 cm, p=0.005), E/Ea ratio (12.2 ± 4.37 vs. 9.2 ± 3.20, p<0.001) were found to be higher in CHF patients with an N/L ratio >3 than with an N/L ratio <3. The N/L ratio, and log-NT-proBNP level were determined to be a predictive factor of poor FC (odds ratio [OR]=3.085, 95% confidence interval [CI]= 1.520-6.260, p=0.002 and OR=1.585, 95% CI=1.201-2.091, p=0.001, respectively). A cut-off point of 2.74 for the N/L ratio had 79.4% sensitivity and 80% specificity in predicting poor FC.
N/L ratio can be used to predict poor FC in patients with CHF.
我们旨在评估代偿性心力衰竭（CHF）患者的中性粒细胞与淋巴细胞比值（N/L比值）与功能能力（FC）之间的关系。
连续纳入94例CHF患者以及70例年龄和性别匹配、超声心动图检查正常的受试者。在所有研究对象中，于超声心动图检查和跑步机测试前采集外周静脉血样本。采用基于改良Bruce方案的跑步机测试来确定CHF患者的功能状态。运动测试中FC差定义为<5代谢当量（MET）。之后，根据N/L比值的高低将CHF患者分为两组。
发现N/L比值>3的CHF患者的FC（3.2±2.05 MET对6.1±2.04 MET，p<0.001）、射血分数（31.5%±7.64对34.8%±6.82，p=0.028）较低，而N末端脑钠肽前体（NT-proBNP）水平（3360±2742 pg/dl对1613±1334 pg/dl，p<0.001）、肺动脉压（46.3±11.50 mmHg对41.5±9.45 mmHg，p=0.049）、左心房直径（4.6±0.52 cm对4.3±0.43 cm，p=0.005）、E/Ea比值（12.2±4.37对9.2±3.20，p<0.001）较高。N/L比值和log-NT-proBNP水平被确定为FC差的预测因素（比值比[OR]=3.085，95%置信区间[CI]=1.520 - 6.260，p=0.002；OR=1.585，95% CI=1.201 - 2.091，p=0.001）。N/L比值的截断点为2.74时，预测FC差的敏感性为79.4%，特异性为80%。
N/L比值可用于预测CHF患者的FC差。
