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Published on: November 8, 2024
Platelet Activity and Its Correlation with Inflammation and Cell Count Readings in Chronic Heart Failure Patients
Aušra Mongirdienė1, Jolanta Laukaitienė1,2, Vilius Skipskis3
1Department of Biochemistry, Medicine Academy, Lithuanian University of Health Sciences, Eiveniu Str. 4, LT-50103 Kaunas, Lithuania.
Insights
Inflammation markers like mean platelet volume (MPV) and white blood cell counts correlate with disease severity in chronic heart failure patients. Increased MPV and neutrophil/monocyte counts may indicate a higher inflammatory state in heart failure with reduced ejection fraction (HFrEF).
Area of Science:
- Cardiology
- Hematology
- Internal Medicine
Background:
- Inflammation plays a critical role in thrombosis complications among chronic heart failure (HF) patients.
- Thrombosis incidence is highest in NYHA IV classified HF patients, suggesting a link between disease severity and thrombotic risk.
- Platelet-induced leukocyte activation is a key mechanism regulating inflammation.
Purpose of the Study:
- To compare platelet and leukocyte counts in chronic heart failure with reduced ejection fraction (HFrEF) patients across NYHA functional classes.
- To evaluate the correlation between platelet and cell counts and NYHA functional class.
- To investigate associations between hematological parameters and markers of cardiac function and inflammation.
Main Methods:
- Analysis of 185 chronic HFrEF patients.
- Assessment of echocardiography, N-terminal pro b-type natriuretic peptide (NT-proBNP), C-reactive protein (CRP), fibrinogen, cortisol, and complete blood counts.
- Determination of platelet aggregation (ADP- and ADR-induced) and 6-minute walking test results.
Main Results:
- Mean platelet volume (MPV) significantly increased with worsening NYHA class (p < 0.005).
- Lymphocyte counts were lowest, while neutrophil and monocyte counts/percentages were highest in NYHA IV patients (p < 0.045).
- NYHA class correlated with MPV, lymphocyte, and monocyte counts. CRP correlated with NT-proBNP, and MPV correlated with fibrinogen concentration.
Conclusions:
- Mean platelet volume (MPV) may serve as an additional indicator of patient condition in HFrEF.
- Elevated neutrophil and monocyte counts suggest a heightened inflammatory state in chronic HFrEF patients.
- Further studies are needed to evaluate MPV's utility in identifying patients at risk for hypercoagulable states.
Abstract:
Background and objectives: 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. Materials and methods: 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. Results: Mean platelet volume (MPV) increased with deterioration of a patient's state (p < 0.005). Lymphocyte count and percentage were the lowest in the NYHA IV group (p < 0.005). Neutrophil and monocyte percentage and count were the highest (p < 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 (p < 0.023). NYHA functional class correlated with mean platelet volume (MPV) (r = 0.311, p = 0.0001), lymphocyte count (r = -0.186, p = 0.026), monocyte count (p = 0.172, p = 0.041), and percentage (r = 0.212, p = 0.011). CRP concentration correlated with NT-proBNP (r = 0.203, p = 0.005). MPV correlated with fibrinogen concentration (r = 0.244, p = 0.004). Conclusions: (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.
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