Kaya Adnan, Tukkan Ceyhan, Alper Ahmet Taha, Gungor Baris, Ozcan Kazim Serhan, Tatlisu Mustafa Adem, Tekkesin Ahmet Ilker, Karadeniz Fatma Ozpamuk, Gok Gulay, Kayapinar Osman
Department of Cardiology, Duzce University Faculty of Medicine, Duzce, Turkey.
Department of Cardiology, Dr. Siyami Ersek Cardiovacular Surgery Hospital, Istanbul, Turkey.
North Clin Istanb. 2017 May 10;4(1):66-72. doi: 10.14744/nci.2017.72324. eCollection 2017.
Red cell distribution width (RDW) and neutrophil to lymphocyte ratio (NLR) have been found to be associated with non-valvular atrial fibrillation (AF) and cardiovascular diseases. However, correlation of these parameters with presence of left atrial (LA) thrombus and/or spontaneous echo contrast (SEC) in patients with non-valvular AF has not been clarified. This study was an investigation of correlation of RDW, NLR, and clinical risk factors with LA thrombus and dense SEC in patients with non-valvular AF in the Turkish population.
The demographic, laboratory, and echocardiographic properties of 619 non-valvular AF patients who underwent transesophageal echocardiography (TEE) examination before direct current cardioversion (DCCV) or AF ablation treatment were retrospectively investigated. Complete blood count (CBC) and biochemical parameters were studied 6 to 12 hours before TEE examination. Left atrial stasis (LAS) markers were noted as presence of left atrial/left atrial appendage (LA/LAA) thrombus or dense spontaneous echo contrast (DSEC).
Total of 325 (52%) patients with LAS were compared with 294 patients (48%) without LAS. In the LAS group, there were 274 (84%) patients with LA/LAA thrombus and 51 (16%) patients with DSEC. LAS (+) group, values for RDW (14.85±1.48 vs. 13.77±1.30; p<0.01), NLR (2.38 [1.58], vs. 2.10 [1.35]; p<0.01) and C-reactive protein (0.95 [0.61] vs. 0.88 [0.60] mg/L; p<0.01) were significantly higher than seen in LAS (-) group. In multivariate regression analysis, increased level of RDW, age, male gender, heart failure, duration of AF >6 months, and international normalized ratio <2 were independently correlated with presence of LAS.
Our study indicated that increased level of RDW is independently correlated with higher risk for development of LAS in patients with non-valvular AF.
红细胞分布宽度（RDW）和中性粒细胞与淋巴细胞比值（NLR）已被发现与非瓣膜性心房颤动（AF）及心血管疾病相关。然而，这些参数与非瓣膜性AF患者左心房（LA）血栓和/或自发显影对比（SEC）的存在之间的相关性尚未明确。本研究旨在调查土耳其人群中非瓣膜性AF患者的RDW、NLR及临床危险因素与LA血栓和致密SEC之间的相关性。
对619例在直流电复律（DCCV）或AF消融治疗前行经食管超声心动图（TEE）检查的非瓣膜性AF患者的人口统计学、实验室及超声心动图特征进行回顾性研究。在TEE检查前6至12小时研究全血细胞计数（CBC）和生化参数。左心房淤滞（LAS）标志物记录为左心房/左心耳（LA/LAA）血栓或致密自发显影对比（DSEC）的存在。
共对325例（52%）有LAS的患者与294例（48%）无LAS的患者进行了比较。在LAS组中，有274例（84%）患者存在LA/LAA血栓，51例（16%）患者存在DSEC。LAS（+）组的RDW值（14.85±1.48对13.77±1.30；p<0.01）、NLR值（2.38[1.58]对2.10[1.35]；p<0.01）和C反应蛋白值（0.95[0.61]对0.88[0.60]mg/L；p<0.01）显著高于LAS（-）组。在多因素回归分析中，RDW水平升高、年龄、男性、心力衰竭、AF持续时间>6个月及国际标准化比值<2与LAS的存在独立相关。
我们的研究表明，RDW水平升高与非瓣膜性AF患者发生LAS的较高风险独立相关。
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