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SII, SIRI, and MHR as Additional Readings for Personalized Evaluation of Chronic Heart Failure Severity
Edis Baubonis1, Jolanta Laukaitienė2, Ingrida Grabauskytė3
1Medicine Academy, Lithuanian University of Health Sciences, Eiveniu Str. 4, LT-50103 Kaunas, Lithuania.
Insights
In chronic heart failure patients, higher monocyte to HDL ratio (MHR) indicates worsening oxidative stress and cardiac function. The utility of SII and SIRI requires further investigation.
Area of Science:
- Cardiology
- Biochemistry
- Hematology
Background:
- Chronic heart failure (CHF) is a complex condition with significant morbidity and mortality.
- Biomarkers reflecting disease severity and underlying pathophysiological processes are crucial for patient management.
- Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-HDL ratio (MHR) are emerging inflammatory markers.
Purpose of the Study:
- To investigate the relationship between SII, SIRI, and MHR with lipidogram, oxidative stress, and echocardiographic parameters in CHF patients.
- To determine if SII, SIRI, and MHR can serve as indicators of disease severity and progression in CHF.
Main Methods:
- A cohort of 220 CHF patients was analyzed.
- Patients were stratified based on SII, SIRI, and MHR levels.
- Comprehensive assessments included lipid profiles, oxidative stress markers, and echocardiography.
Main Results:
- No significant differences in lipidogram, oxidative stress, or echocardiography were found between SII and SIRI groups.
- Higher MHR was associated with lower HDL, increased left ventricular end-diastolic diameter (LVEDD), left ventricular mass (LVMM), myocardial mass index (MMI), and decreased left ventricular ejection fraction (LVEF).
- MHR correlated with oxidative stress markers (protein carbonyl, nitrotyrosine) and cardiac remodeling indices (MMI, LVMI).
Conclusions:
- MHR may serve as a valuable indicator of worsening oxidative stress and cardiac dysfunction in CHF patients.
- The clinical utility of SII and SIRI in CHF requires further validation.
Abstract:
(1) The aim of the study was to reveal what differences in patients' lipidogram, oxidative stress, and echocardiographic readings are reflected by SII, SIRI, and MHR of the patients with chronic heart failure (CHF). (2) A total of 220 patients diagnosed with CHF were investigated. They were stratified into groups according to averages of SII (neutrophil * platelet/lymphocyte count), SII ≤ 684.757 (n = 115), and SII > 684.757 (n = 62); SIRI (neutrophil * monocyte/lymphocyte count), SIRI ≤ 2.098 (n = 110), SIRI > 2.098 (n = 67); and monocyte count/high-density lipoprotein cholesterol concentration (MHR), MHR ≤ 0.5854 (n = 54), and MHR > 0.5854 (n = 64) values. The analysis of transthoracic echocardiogram, complete blood count test, C reactive protein, lipidogram, oxHDL, nitrotirozine, ditirozine, TAC, protein carbonyl, catalase, and MDA were performed; (3) Between the groups, according to SII and SIRI, there were no statistically significant differences in lipidogram, oxidative stress, and echocardiography readings. In those with higher MHR, HDL concentration was lower (0.91 (0.44; 1.45) and 1.27 (0.72; 2.69), p < 0.001). In those with higher MHR, LVEDD was higher (58.12 (10.03) and 51.53 (10.34), p < 0.001), LVMM was higher (274.92 (92.24) and 233.07 (74.84), p = 0.010), MMI was higher (130.88 (34.28; 227.97) and 114.27 (70.34; 270.00), p = 0.022), and LVEF was lower (28.5 (10.0; 55.0) and 40.0 (20.0; 55.0), p < 0.001). MHR correlated with MMI (r = 0.287, p = 0.028) and LVMI (r = 0.287, p = 0.028). Nitrotyrosine concentration was higher in those with higher MHR (4.52 (1.12; 93.58) and 3.52 (1.74; 28.32), p = 0.022). MHR correlated with protein carbonyl (r = 0.321, p = 0.013), nitrotyrosine concentration (r = 0.356, p = 0.006). SIRI correlated with carbonyl protein concentration (r = 0.321, p = 0.013); (4) 1. In CHF patients, MHR could reflect the worsening of patients' conditions related to oxidative stress. 2. The possibility to use SII and SIRI still needs to be confirmed.
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