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Factores de resonancia magnética clínica y cardiovascular asociados con una relación elevada de neutrófilos a

Patrick Thompson1, Millie Duckett1, Raluca Tomoaia1

  • 1Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.

BMJ open
|August 27, 2025
PubMed
Resumen

En la insuficiencia cardíaca con fracción de eyección reducida (HF-rEF), una relación elevada de neutrófilos a linfocitos (NLR) está relacionada con el empeoramiento de la congestión y la enfermedad coronaria oculta. Se necesita más investigación para confirmar si esto predice resultados adversos.

Palabras clave:
Insuficiencia cardíacaLa inflamaciónImágenes por resonancia magnética

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Área de la Ciencia:

  • Cardiología
  • Hematología
  • Imágenes médicas

Sus antecedentes:

  • La relación neutrófilos/ linfocitos (RNL) es un marcador estudiado en diversas condiciones.
  • Un NLR elevado en la insuficiencia cardíaca con fracción de eyección reducida (HF-rEF) indica un mayor riesgo de resultados adversos.
  • La identificación de los factores asociados con un NLR elevado en HF-rEF es crucial para la estratificación del riesgo.

Objetivo del estudio:

  • Investigar la asociación entre los factores clínicos, los parámetros de la resonancia magnética cardiovascular (CMR, por sus siglas en inglés) y un NLR elevado en pacientes con HF-rEF.
  • Determinar qué factores predicen de forma independiente un NLR elevado en esta población de pacientes.

Principales métodos:

  • Análisis del prospectivo registro MATCH, que incluye a 605 pacientes con reciente diagnóstico de HF-rEF referidos para CMR.
  • Se realizaron evaluaciones clínicas, hemograma y CMR (incluido el flujo sanguíneo miocárdico, la mejora tardía del gadolinio y el mapeo paramétrico).
  • Se utilizó la regresión lineal para examinar las asociaciones entre los parámetros NLR y los parámetros clínicos/CMR.

Principales resultados:

  • El NLR elevado se asoció significativamente con la edad, la fibrilación auricular, el NT-proBNP, la fibrosis isquémica y la reserva de perfusión miocárdica (MPR).
  • Después de la regresión multivariable, la NLR se mantuvo significativamente asociada con la fibrosis isquémica y el NT-proBNP.
  • No se encontró asociación entre los marcadores de inflamación NLR y CMR (T1 y T2 nativos).

Conclusiones:

  • En pacientes con FH-rEF, un NLR elevado está asociado con el empeoramiento de la congestión (indicado por NT-proBNP) y la enfermedad coronaria oculta (fibrosis isquémica).
  • El estudio no encontró una asociación entre la NLR y la inflamación o el edema del miocardio.
  • Se requiere una investigación adicional para determinar si el NLR elevado predice un pronóstico adverso en HF-rEF.