Department of Biochemistry, Medicine Academy, Lithuanian University of Health Sciences, Eiveniu Str. 4, LT-50103 Kaunas, Lithuania.
Cardiology Clinic, University Hospital, Lithuanian University of Health Sciences, Eiveniu Str. 2, LT-50161 Kaunas, Lithuania.
Medicina (Kaunas). 2021 Feb 18;57(2):176. doi: 10.3390/medicina57020176.
: There has been an increasing interest in the role of inflammation in thrombosis complications in chronic heart failure (HF) patients. The incidence of thrombosis in HF has been shown to be the highest in patients classified as NYHA IV (New York Heart association). It is stated that inflammation is regulated by platelet-induced activation of blood leukocytes. We aimed to compare the platelet and cell count readings in chronic HF with reduced ejection fraction (HFrEF) patients according to NYHA functional class and to evaluate the correlation between those readings. : A total of 185 patients were examined. The results of heart echoscopy (TEE) testing; fibrinogen, N-terminal pro b-type natriuretic peptide (NT-proBNP), C reactive protein (CRP), and cortisol concentrations; complete blood counts; and a 6 min walking test were assessed and platelet aggregation was determined. : Mean platelet volume (MPV) increased with deterioration of a patient's state ( < 0.005). Lymphocyte count and percentage were the lowest in the NYHA IV group ( < 0.005). Neutrophil and monocyte percentage and count were the highest ( < 0.045) in the NYHA IV group. Adenosine diphosphate (ADP)- and ADR-induced platelet aggregation was higher in the NYHA III group compared to NYHA II and I groups ( < 0.023). NYHA functional class correlated with mean platelet volume (MPV) (r = 0.311, = 0.0001), lymphocyte count (r = -0.186, = 0.026), monocyte count ( = 0.172, = 0.041), and percentage (r = 0.212, = 0.011). CRP concentration correlated with NT-proBNP (r = 0.203, = 0.005). MPV correlated with fibrinogen concentration (r = 0.244, = 0.004). : (1) MPV could be considered as an additional reading reflecting a patient's condition, however the use of MPV to identify patients at risk of hypercoagulable state should be evaluated in more extensive studies; (2) increased neutrophil and monocyte counts could indicate a higher inflammatory state in chronic HFrEF.
炎症在慢性心力衰竭（HF）患者血栓并发症中的作用引起了越来越多的关注。HF 患者的血栓发生率在纽约心脏协会（NYHA）分类为 IV 级的患者中最高。据报道，炎症受血小板诱导的血液白细胞激活调节。我们旨在根据 NYHA 功能分类比较慢性射血分数降低性心力衰竭（HFrEF）患者的血小板和细胞计数读数，并评估这些读数之间的相关性。
共检查了 185 例患者。评估了心脏超声心动图（TEE）检查结果；纤维蛋白原、N 末端 pro B 型利钠肽（NT-proBNP）、C 反应蛋白（CRP）和皮质醇浓度；全血细胞计数；以及 6 分钟步行试验，并确定了血小板聚集。
平均血小板体积（MPV）随患者病情恶化而升高（<0.005）。淋巴细胞计数和百分比在 NYHA IV 组最低（<0.005）。中性粒细胞和单核细胞百分比和计数在 NYHA IV 组最高（<0.045）。与 NYHA II 和 I 组相比，ADP 和 ADR 诱导的血小板聚集在 NYHA III 组更高（<0.023）。NYHA 功能分类与平均血小板体积（MPV）（r = 0.311， = 0.0001）、淋巴细胞计数（r = -0.186， = 0.026）、单核细胞计数（ = 0.172， = 0.041）和百分比（r = 0.212， = 0.011）相关。CRP 浓度与 NT-proBNP 相关（r = 0.203， = 0.005）。MPV 与纤维蛋白原浓度相关（r = 0.244， = 0.004）。
（1）MPV 可作为反映患者病情的附加指标，但需要在更广泛的研究中评估使用 MPV 来识别易发生高凝状态的患者；（2）中性粒细胞和单核细胞计数增加可能表明慢性 HFrEF 中的炎症状态更高。
