Neutrophil to Lymphocyte Ratio as a Predictor of Left Ventricular Hypertrophy in Patients with Newly Diagnosed Hypertension

Afşin, Abdülmecit; Ramazan, Asoğlu; Kurtoğlu, Ertuğrul; Kaya, Hakan

doi:10.23937/2474-3690/1510042

Cited by 6 publications

(9 citation statements)

References 35 publications

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“…24 Additionally, Afşin et al showed by linear regression analysis that LVMi was independently correlated with NLR. 7 In hypertensive children, NLR was found to also be predictive of diastolic dysfunction. 19 Additionally, in patients with chronic kidney disease, NLR has been positively associated with LV diastolic dysfunction with a predictive value of ~3.…”

Section: Resultsmentioning

confidence: 96%

“…18 In patients with hypertension, elevated NLR has been shown to be an independent determinant of LV hypertrophy (LVH) and is positively associated with diastolic dysfunction. 7,19 Likewise, in patients with T2D, an elevated NLRis associated with increased CV events. 20 The relationship between NLR and LV mass in people with diabetes remains unclear.…”

Section: Introductionmentioning

confidence: 99%

“…Increased neutrophil‐to‐lymphocyte ratio (NLR) has been identified as a biomarker of systemic inflammation and CV disease. 7 , 8 , 9 , 10 NLR is derived from the absolute neutrophil count divided by the absolute lymphocyte count. Increased absolute neutrophil count is positively associated with adverse CV events, 9 , 11 , 12 , 13 , 14 , 15 whereas lymphocytes are suggested to be anti‐atherosclerotic and lymphocyte counts are lower in patients with vascular disease.…”

Section: Introductionmentioning

confidence: 99%

“…Inflammation plays an important role in cardiac reverse remodelling and cardiovascular (CV) outcomes. Increased neutrophil‐to‐lymphocyte ratio (NLR) has been identified as a biomarker of systemic inflammation and CV disease 7–10 . NLR is derived from the absolute neutrophil count divided by the absolute lymphocyte count.…”

Section: Introductionmentioning

confidence: 99%

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Baseline neutrophil‐to‐lymphocyte ratio and efficacy of SGLT2 inhibition with empagliflozin on cardiac remodelling

et al. 2023

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Aims The neutrophil‐to‐lymphocyte ratio (NLR) is a marker of systemic inflammation and plays a critical role in the assessment and prognosis in patients with heart failure. The EMPA‐HEART CardioLink‐6 trial demonstrated that patients with type 2 diabetes (T2D) and coronary artery disease (CAD) treated with a sodium–glucose transport protein 2 inhibitor for 6 months experienced regression in left ventricular mass. Given this, we evaluated the relationship of baseline NLR and cardiac reverse remodelling in the entire cohort of this trial. Methods and results A total of 97 individuals were randomized to receive empagliflozin (10 mg/day) or placebo for 6 months. The primary outcome of the trial was change in left ventricular mass indexed to body surface area (LVMi) from baseline to 6 months as measured by cardiac magnetic resonance imaging. In our analysis, the cohort was stratified above and below an NLR level of 2. To assess the treatment effect on the 6 month change in NLR, we used a linear model adjusting for baseline differences in NLR [analysis of covariance (ANCOVA)] that included an interaction term between the baseline NLR and treatment. To assess the treatment effect on the 6 month change in LVMi in each of the subgroups divided by baseline NLR, we used an ANCOVA adjusting for baseline differences in LVMi that included an interaction term between the subgroups and treatment. The results of the regression models were summarized as adjusted differences with two‐sided 95% confidence intervals (CIs). Patients who exhibited an elevated baseline NLR demonstrated higher LVMi and left ventricular end‐diastolic volume indexed to body surface area than those with a lower NLR. In patients with an NLR < 2 and NLR ≥ 2, the adjusted difference in LVMi between the empagliflozin‐ and placebo‐treated patients was −2.98 g/m2 (95% CI: −6.18 to 0.22 g/m2) (P value = 0.067) and −4.43 g/m2 (95% CI: −8.50 to −1.11 g/m2), respectively (Pinteraction = 0.60). Conclusions Empagliflozin treatment is associated with consistent reductions in LVMi in patients with T2D and CAD independent of baseline NLR.

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Section: Resultsmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Baseline neutrophil‐to‐lymphocyte ratio and efficacy of SGLT2 inhibition with empagliflozin on cardiac remodelling

et al. 2023

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“…Neutrophils are the first leukocytes that appear in the myocardium following pressure overload-induced hypertrophy, within 3 days after the injury (Weisheit et al, 2014(Weisheit et al, , 2021 (Figure 1A, bottom panel). In patients with concentric or eccentric LV hypertrophy, blood neutrophil-to-lymphocyte ratio (NLR) was elevated and correlated strongly with the LV mass index (r = 0.508, p < 0.001) (Afşin et al, 2019). Neutrophil transmigration is dependent on endothelial cell activation and subsequent expression of adhesion molecules (Woodfin et al, 2009;Filippi, 2019), a process that is enhanced by inflammatory stimuli, such as TNF-α, IL1β, and even MC-derived histamine (Mackay et al, 1993;Asako et al, 1994;Sahni et al, 2005).…”

Section: Neutrophilsmentioning

confidence: 99%

Innate Immune Cells in Pressure Overload-Induced Cardiac Hypertrophy and Remodeling

Liu

Shi

Guo

2021

Front. Cell Dev. Biol.

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Pressure overload and heart failure are among the leading causes of cardiovascular morbidity and mortality. Accumulating evidence suggests that inflammatory cell activation and release of inflammatory mediators are of vital importance during the pathogenesis of these cardiac diseases. Yet, the roles of innate immune cells and subsequent inflammatory events in these processes remain poorly understood. Here, we outline the possible underlying mechanisms of innate immune cell participation, including mast cells, macrophages, monocytes, neutrophils, dendritic cells, eosinophils, and natural killer T cells in these pathological processes. Although these cells accumulate in the atrium or ventricles at different time points after pressure overload, their cardioprotective or cardiodestructive activities differ from each other. Among them, mast cells, neutrophils, and dendritic cells exert detrimental function in experimental models, whereas eosinophils and natural killer T cells display cardioprotective activities. Depending on their subsets, macrophages and monocytes may exacerbate cardiodysfunction or negatively regulate cardiac hypertrophy and remodeling. Pressure overload stimulates the secretion of cytokines, chemokines, and growth factors from innate immune cells and even resident cardiomyocytes that together assist innate immune cell infiltration into injured heart. These infiltrates are involved in pro-hypertrophic events and cardiac fibroblast activation. Immune regulation of cardiac innate immune cells becomes a promising therapeutic approach in experimental cardiac disease treatment, highlighting the significance of their clinical evaluation in humans.

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The heart under pressure: immune cells in fibrotic remodeling

Theall

Alcaide

2022

Current Opinion in Physiology

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Neutrophil to Lymphocyte Ratio as a Predictor of Left Ventricular Hypertrophy in Patients with Newly Diagnosed Hypertension

Cited by 6 publications

References 35 publications

Baseline neutrophil‐to‐lymphocyte ratio and efficacy of SGLT2 inhibition with empagliflozin on cardiac remodelling

Baseline neutrophil‐to‐lymphocyte ratio and efficacy of SGLT2 inhibition with empagliflozin on cardiac remodelling

Innate Immune Cells in Pressure Overload-Induced Cardiac Hypertrophy and Remodeling

The heart under pressure: immune cells in fibrotic remodeling

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