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The relationship between neutrophil/lymphocyte ratio and calcific aortic stenosis
Anil Avci1, Alizade Elnur, Acar Göksel
1Cardiology Deparment, Kartal Koşuyolu Heart Research and Training Hospital, Istanbul, Turkey.
Insights
The neutrophil-to-lymphocyte ratio (NLR) is higher in patients with severe aortic stenosis (AS) and reduced left ventricular systolic function. Increased NLR indicates more severe calcific AS and LV dysfunction.
Area of Science:
- Cardiology
- Inflammation Research
- Atherosclerosis Studies
Background:
- Inflammation plays a similar role in atherosclerosis and aortic stenosis (AS).
- Systemic inflammation is linked to heart failure.
- Neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation.
Purpose of the Study:
- To investigate the association between NLR and the severity of calcific AS.
- To examine the relationship between NLR and left ventricular (LV) systolic dysfunction in severe calcific AS patients.
Main Methods:
- Retrospective study of 96 calcific AS patients (2011-2013).
- AS severity graded by transaortic mean pressure gradient.
- Patients categorized into mild-to-moderate AS, severe AS with normal LVEF, and severe AS with reduced LVEF.
Main Results:
- NLR was significantly higher in severe AS with reduced LVEF compared to other groups (3.94 ± 0.88).
- NLR was also higher in severe AS with normal LVEF versus mild-to-moderate AS (2.69 ± 1.00 vs. 2.05 ± 0.64).
- NLR correlated with transaortic mean pressure gradient and aortic valve peak velocity in mild-to-severe AS with normal LVEF.
Conclusions:
- Elevated NLR is associated with the severity of calcific AS.
- Increased NLR is linked to left ventricular systolic dysfunction in severe calcific AS.
Background:
The role of inflammation in fibrotic and calcific processes of atherosclerosis and aortic stenosis (AS) is similar. Furthermore, a relationship between systemic inflammation and heart failure has been well demonstrated. Recently, neutrophil/lymphocyte ratio (NLR) has been proposed as a predictive marker of systemic inflammation. We investigated the association of NLR with the severity of calcific AS and left ventricular (LV) systolic dysfunction in patients with severe calcific AS.
Methods:
A total of 96 patients with calcific AS were included in this retrospective study from 2011 to 2013. The severity of AS was graded according to the transaortic mean pressure gradient. The patients were divided into 3 groups as mild-to-moderate AS, severe AS with normal left ventricular ejection fraction (LVEF), and severe AS with reduced LVEF (mean gradient >40 mmHg and LVEF <50%).
Results:
Neutrophil/lymphocyte ratio was significantly higher in severe calcific AS with reduced LVEF group than the other 2 groups (3.94 ± 0.88, P < 0.001). In addition, NLR was higher in severe AS with normal LVEF group than mild-to-moderate AS group (2.69 ± 1.00 vs. 2.05 ± 0.64, P = 0.008). There was a statistically significant correlation between NLR and both transaortic mean pressure gradient and aortic valve peak velocity in patients with mild-to-severe AS with normal LVEF (n = 81; r = 0.369, P < 0.001; r = 0.290, P = 0.004; respectively).
Conclusion:
Increased NLR is related to the severity of calcific AS and LV systolic dysfunction in patients with severe calcific AS.
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