Department of Cardiology, Faculty of Medicine, Atılım University, Medicana International Ankara Hospital, Ankara, Turkey
Department of Cardiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
Turk J Med Sci. 2020 Aug 26;50(5):1307-1313. doi: 10.3906/sag-2006-60.
BACKGROUND/AIM: From a pathophysiological point of view, inflammation is thought to be more dominant in bicuspid aortic valve (BAV) stenosis than tricuspid aortic valve (TAV) stenosis. Our study aimed to determine the association between monocyte to high- density lipoprotein cholesterol (HDL-C) ratio (MHR), a new inflammatory marker, and the speed of progression of stenosis and pathophysiology of BAV stenosis.
A total of 210 severe aortic stenosis patients (70 consecutive BAV patients, 140 matched TAV patients) were retrospectively enrolled in the study. Clinical and echocardiographic data and laboratory results related to our research were collected retrospectively from the patients’ records. MHR was measured as the ratio of the absolute monocyte count to the HDL-C value.
Seventy BAV (mean age: 72.0 ± 9.1 years, 42.9% female) and 140 TAV patients (mean age: 77.9 ± 8.3 years, 51.4% female) with severe aortic stenosis were enrolled in this study. There was no difference between the two groups in terms of another baseline demographic or clinic findings except age (P < 0.001). Monocyte count, hemoglobin level, mean platelet volume was significantly higher, and HDL-C level was significantly lower in the BAV group, while other lipid and CBC parameters were found to be similar. In the multivariate analysis, MHR (P = 0.005, 95% CI: 0.90–0.98) and, as expected, age (P = 0.001, 95% CI: 1.02–1.11) were found to be significant as the independent predictor of BAV, after adjusting for other risk factors.
Our study showed a significant correlation between increased MHR and BAV. MHR was determined as a significant independent predictor for the speed of progression and diagnosis of severe BAV stenosis in multivariate analysis.
背景/目的：从病理生理学的角度来看，炎症在二叶式主动脉瓣（BAV）狭窄中比三叶式主动脉瓣（TAV）狭窄更为明显。我们的研究旨在确定单核细胞与高密度脂蛋白胆固醇（HDL-C）比值（MHR），一种新的炎症标志物，与 BAV 狭窄的狭窄进展速度和病理生理学之间的关系。
共回顾性纳入 210 例严重主动脉瓣狭窄患者（70 例连续 BAV 患者，140 例匹配的 TAV 患者）。从患者的记录中回顾性收集与我们的研究相关的临床和超声心动图数据以及实验室结果。MHR 测量为绝对单核细胞计数与 HDL-C 值的比值。
本研究纳入了 70 例 BAV（平均年龄：72.0 ± 9.1 岁，42.9%为女性）和 140 例 TAV 患者（平均年龄：77.9 ± 8.3 岁，51.4%为女性），这些患者均患有严重的主动脉瓣狭窄。两组患者的其他基线人口统计学或临床发现除年龄外无差异（P < 0.001）。BAV 组的单核细胞计数、血红蛋白水平、平均血小板体积显著升高，HDL-C 水平显著降低，而其他血脂和 CBC 参数则相似。多变量分析显示，MHR（P = 0.005，95%CI：0.90-0.98）和年龄（P = 0.001，95%CI：1.02-1.11）与 BAV 显著相关，在调整了其他危险因素后。
我们的研究表明，MHR 升高与 BAV 之间存在显著相关性。MHR 在多变量分析中被确定为严重 BAV 狭窄进展速度和诊断的独立预测因子。
