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Updated: Jun 3, 2025
Flow Cytometry-Based Quantification and Analysis of Myocardial B-Cells
Published on: August 17, 2022
The Effects of Beta-Blockers on Leukocytes and the Leukocyte Subpopulation in Heart Failure Patients
Anca Daniela Farcaş1,2, Mirela Anca Stoia1,2, Diana Larisa Mocan-Hognogi1,2
1Internal Medicine Department, Faculty of Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania.
Insights
Beta-blockers (BBs) impact white blood cell (WBC) counts in heart failure (HF) patients. Metoprolol increased lymphocytes and lowered the neutrophil/lymphocyte ratio (NLR), while carvedilol had opposite effects, though both improved outcomes.
Area of Science:
- Cardiology
- Hematology
- Pharmacology
Background:
- White blood cells (WBCs) and the neutrophil/lymphocyte ratio (NLR) are prognostic markers in heart failure (HF).
- Catecholamines influence WBC redistribution, suggesting beta-blockers (BBs) may affect these parameters.
Purpose of the Study:
- To investigate the influence of different beta-blocker (BB) types on WBC redistribution in HF patients.
- To assess the differential effects of Metoprolol and Carvedilol on neutrophil and lymphocyte counts and NLR.
Main Methods:
- Clinical evaluation of HF patients and blood analysis for WBC differential counts and N-Terminal pro-B-type natriuretic peptide (NT-proBNP).
- Comparison of WBC parameters and NT-proBNP levels between patients on BBs versus those not on BBs.
- Analysis of the impact of Metoprolol (Met) and Carvedilol (Car) dosage and type on WBC counts and NLR.
Main Results:
- Patients on BBs showed lower NLR and NT-proBNP on admission compared to those without BBs.
- Metoprolol treatment (≥100 mg/day) was associated with increased lymphocytes and reduced NLR.
- Carvedilol treatment (≥25 mg/day) was associated with decreased lymphocytes, increased neutrophils, and elevated NLR.
Conclusions:
- Different BBs exert distinct effects on WBC differential counts and NLR in HF patients.
- Despite differential effects on WBCs, both Metoprolol and Carvedilol demonstrated similar rehospitalization rates and improved outcomes over 12 months.
Abstract:
Background/Objectives: Some specific types of white blood cells (WBCs) and the neutrophil/lymphocyte ratio (NLR) are independent predictors of outcome for heart failure (HF) patients. WBC redistribution is induced by catecholamines, and therefore we evaluate how different types of beta-blockers (BBs) influence it. Methods: The HF patients were clinically evaluated, and blood was drawn to measure N-Terminal pro-B-type natriuretic peptide (NT-proBNP), WBC-differential formula, etc. Results: On admission, 61.16% of patients who used a BB had no significant difference in the number of lymphocytes (Lym) and neutrophils (Neu), but NLR and NT- proBNP were significantly lower compared with those without BB. NT-proBNP correlated with BB dose on admission and was significantly lower in patients treated with Metoprolol (Met) as compared with Carvedilol (Car). The type and dose of BB used was responsible for 6.1% and 5.9% of the variability in the number of Lym and Neu, respectively. Patients treated with ≥100 mg Met/day had a higher Lym number, but not of Neu, with reduced NLR, compared with lower doses. Patients treated with ≥25 mg Car/day had a lower Lym number and a greater Neu number, compared with lower doses, with increased NLR. Conclusions: However, both BBs had the same rehospitalization rate during the 12 month follow-up and had an improved outcome.
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