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Circulating Monocyte Count as a Surrogate Marker for Ventricular-Arterial Remodeling and Incident Heart Failure with
Kuang-Te Wang1, Yen-Yu Liu2, Kuo-Tzu Sung3,4
1Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taitung Branch, Taitung 95054, Taiwan.
Insights
Higher white blood cell and monocyte counts are linked to larger carotid arteries and increased heart failure risk. Elevated monocytes and common carotid artery diameter indicate the highest risk for heart failure.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Public Health
Background:
- Inflammation and immune cell counts are implicated in cardiovascular disease.
- Monocytes play a role in atherosclerosis and cardiac remodeling.
- Common carotid artery diameter (CCAD) is a marker of vascular health.
Purpose of the Study:
- To investigate the association between white blood cell (WBC) counts, specifically monocytes, and common carotid artery diameter (CCAD).
- To determine the relationship between these markers and the risk of heart failure (HF) and all-cause death.
- To explore the role of monocytes in cardiac remodeling and the pathophysiology of heart failure with preserved ejection fraction (HFpEF).
Main Methods:
- Cross-sectional analysis of 2085 asymptomatic subjects with data on CCAD and WBC counts.
- Multivariate regression models to assess independent associations.
- Survival analysis over a median of 12.1 years to evaluate risk of HF/all-cause death.
Main Results:
- Higher WBC and monocyte counts were associated with greater relative wall thickness and larger CCADs, particularly in men and obese individuals.
- Monocyte count independently predicted left ventricular mass index (LVMi).
- Elevated WBC, segmented cells, monocyte counts, and larger CCAD were independently associated with higher HF/all-cause death risk. The highest risk was observed in individuals with both high CCAD and high monocyte counts (aHR: 2.81).
Conclusions:
- Elevated monocyte counts are associated with cardiac remodeling and carotid artery dilation.
- A phenotype characterized by high monocyte count and large CCAD confers the highest risk of heart failure.
- Circulating monocytes likely play a significant role in the pathophysiology of HFpEF.
Abstract:
Among 2085 asymptomatic subjects (age: 51.0±10.7 years, 41.3% female) with data available on common carotid artery diameter (CCAD) and circulating total white blood cell (WBC) counts, higher circulating leukocytes positively correlated with higher high sensitivity C-reactive protein (hs-CRP).Higher WBC/segmented cells and monocyte counts were independently associated with greater relative wall thicknesses and larger CCADs,which in generalweremore pronounced in men and obese subjects (body mass index ≥ 25kg/m2) (all P interaction: < 0.05). Using multivariate adjusting models, only the monocyte count independently predicted theleft ventricularmass index (LVMi) (ß-Coef: 0.06, p = 0.01). Higher circulating WBC, segmented,and monocyte counts and a greater CCAD were all independently associated with a higher risk of heart failure (HF)/all-cause death during a median of 12.1 years of follow-up in fully adjusted models, with individuals manifesting both higher CCADs and monocyte countsincurring the highest risk of HF/death (adjusted hazard ratio: 2.81, 95% CI: 1.57. -5.03, p< 0.001; P interaction, 0.035; lower CCAD/lower monocyte as reference). We conclude that a higher monocyte count is associated with cardiac remodeling and carotid artery dilation.Both an elevated monocyte count and a larger CCAD may indicate a specific phenotype that confers the highest risk of HF, which likely signifies the role of circulating monocytes in the pathophysiology of heart failure with preserved ejection fraction (HFpEF).
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