Neutrophil to lymphocyte ratio predicts poor functional capacity in patients with heart failure

Area of Science:

• Cardiology
• Clinical Medicine
• Biomarkers

Background:

• Compensated heart failure (CHF) is a clinical condition requiring effective prognostic markers.
• Functional capacity (FC) is a key indicator of prognosis in CHF patients.
• The neutrophil to lymphocyte ratio (N/L ratio) is an emerging inflammatory marker.

Purpose of the Study:

• To investigate the association between the N/L ratio and FC in patients with CHF.
• To determine if the N/L ratio can serve as a predictor of poor functional capacity in this population.

Main Methods:

• A cohort of 94 CHF patients and 70 healthy controls underwent echocardiography and treadmill testing.
• Peripheral venous blood samples were analyzed for N/L ratio.
• Functional capacity was assessed using the modified Bruce protocol, with poor FC defined as <5 metabolic equivalents (METs).

Main Results:

• CHF patients with an N/L ratio >3 exhibited significantly lower FC (3.2 ± 2.05 MET) compared to those with an N/L ratio <3 (6.1 ± 2.04 MET).
• Higher N/L ratios correlated with reduced ejection fraction, elevated NT-proBNP levels, increased pulmonary artery pressure, larger left atrial diameters, and higher E/Ea ratios.
• The N/L ratio (OR=3.085) and log-NT-proBNP (OR=1.585) were significant predictors of poor FC, with an N/L ratio cut-off of 2.74 demonstrating 79.4% sensitivity and 80% specificity.

Conclusions:

• The N/L ratio is a valuable and independent predictor of poor functional capacity in patients with CHF.
• This simple blood-based marker can aid in risk stratification and management of CHF patients.
• The N/L ratio offers a potential tool for identifying CHF patients at higher risk of functional limitation.