Bećirović Emir, Bećirović Minela, Ljuca Kenana, Babić Mirza, Bećirović Amir, Ljuca Nadina, Babić Jušić Zarina, Abdić Admir, Buljubašić Lemana, Begagić Emir
Internal Medicine Clinic, University Clinical Centre Tuzla, Tuzla, BIH.
Gynecology and Obstetrics, University Clinical Centre Ljubljana, Ljubljana, SVN.
Cureus. 2025 Mar 6;17(3):e80159. doi: 10.7759/cureus.80159. eCollection 2025 Mar.
Background Heart failure (HF) is characterized by impaired cardiac function. Based on left ventricular ejection fraction (LVEF), it is classified into HF with reduced ejection fraction (HFrEF), mildly reduced ejection fraction (HFmrEF), and preserved ejection fraction (HFpEF). Each phenotype has distinct pathophysiological mechanisms and clinical features. Recent findings indicate that systemic inflammation is a significant factor in the progression of heart failure. Inflammatory biomarkers, including neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and lymphocyte-to-monocyte ratio (LMR), may serve as valuable tools for evaluating the inflammatory response in heart failure. Materials and methods This prospective observational study, which included 171 HF patients, was conducted from February 2022 to January 2023 at the Intensive Care Unit, University Clinical Centre Tuzla. Based on LVEF, patients were categorized into HFrEF, HFmrEF, and a control group (HFpEF). The study aimed to assess the prognostic value of NLR, MLR, and LMR in predicting major adverse cardiovascular events (MACE) and mortality over a 12-month follow-up period. Results NLR and MLR were significantly higher, while LMR was lower in both HFrEF and HFmrEF compared to controls, indicating a strong inflammatory response, particularly in HFrEF. NLR demonstrated a strong ability to distinguish between HF phenotypes. HFmrEF's markedly higher high-sensitivity troponin I (hsTroponin I) level suggested higher cardiac stress. MACE rates were similar across groups; mortality was significantly higher in HFrEF. Conclusion Inflammatory biomarkers NLR, MLR, LMR, and hsTroponin I could be crucial in assessing heart failure, particularly in patients with HFrEF and HFmrEF.
背景 心力衰竭（HF）的特征是心脏功能受损。根据左心室射血分数（LVEF），可将其分为射血分数降低的心力衰竭（HFrEF）、射血分数轻度降低的心力衰竭（HFmrEF）和射血分数保留的心力衰竭（HFpEF）。每种表型都有独特的病理生理机制和临床特征。最近的研究结果表明，全身炎症是心力衰竭进展的一个重要因素。包括中性粒细胞与淋巴细胞比率（NLR）、单核细胞与淋巴细胞比率（MLR）和淋巴细胞与单核细胞比率（LMR）在内的炎症生物标志物，可能是评估心力衰竭炎症反应的有价值工具。
材料与方法 这项前瞻性观察性研究纳入了171例HF患者，于2022年2月至2023年1月在图兹拉大学临床中心重症监护病房进行。根据LVEF，将患者分为HFrEF组、HFmrEF组和对照组（HFpEF）。该研究旨在评估NLR、MLR和LMR在预测12个月随访期内主要不良心血管事件（MACE）和死亡率方面的预后价值。
结果 与对照组相比，HFrEF组和HFmrEF组的NLR和MLR显著升高，而LMR降低，表明存在强烈的炎症反应，尤其是在HFrEF组。NLR显示出区分HF表型的强大能力。HFmrEF组明显更高的高敏肌钙蛋白I（hsTroponin I）水平表明心脏应激更高。各组的MACE发生率相似；HFrEF组的死亡率显著更高。
结论 炎症生物标志物NLR、MLR、LMR和hsTroponin I在评估心力衰竭方面可能至关重要，尤其是在HFrEF和HFmrEF患者中。
