Prognostic Significance of Peripheral Monocyte Counts in Patients With Chronic Heart Failure

Area of Science:

• Cardiology
• Immunology
• Internal Medicine

Background:

• Heart failure (HF) encompasses distinct pathophysiological states, including HF with preserved ejection fraction (HFpEF) and non-HFpEF.
• Monocytes, key components of the innate immune system, may play a role in HF prognosis.

Purpose of the Study:

• To investigate the prognostic value of peripheral monocyte counts in predicting HF-related events.
• To differentiate the prognostic significance of monocyte counts between HFpEF and non-HFpEF patient groups.

Main Methods:

• A cohort of 678 hospitalized HF patients was divided into HFpEF and non-HFpEF groups based on left ventricular ejection fraction (LVEF).
• Patients were classified into high or low monocyte count groups based on median values specific to each LVEF category.
• Receiver operating characteristic (ROC) analysis and multivariate Cox hazard analysis were employed to assess the association between monocyte counts and HF-related events.

Main Results:

• High peripheral monocyte counts (≥363/mm³ for non-HFpEF, ≥322/mm³ for HFpEF) were associated with increased HF-related events in the non-HFpEF group.
• No significant difference in HF-related events was observed between high and low monocyte groups in the HFpEF cohort.
• Multivariate analysis confirmed high monocyte count as an independent predictor of future HF-related events exclusively in non-HFpEF patients.

Conclusions:

• Elevated peripheral monocyte count is an independent and incremental predictor of HF-related events in patients with non-HFpEF.
• Peripheral monocyte counts do not appear to have significant prognostic value for HF-related events in patients with HFpEF.