Neutrophil-to-lymphocyte ratio is increased in patients with rheumatic mitral valve stenosis?

Abstract

ObjectiveThe role of systemic and chronic inflammatory processes in the pathophysiology of rheumatic heart valve disease is well known. The neutrophil-to-lymphocyte ratio (NLR) was shown to be an indicator of systemic inflammation. In this study, we aimed to investigate relationship between NLR as a marker of systemic inflammation and rheumatic mitral valve stenosis (RMVS).MethodsThis is a retrospective study. Among patients who underwent transthoracic echocardiography between January 2008-March 2013, 314 patients with RMVS were included retrospectively in the study. The control group included 57 healthy persons who underwent transthoracic echocardiography during the study period. Basal characteristics and NLR were compared between the two groups. Independent predictors of RMVS were determined by logistic regression analysis.ResultsBasal characteristics were similar among the groups (age, 50.2±14.2 vs. 49.2±13.0, p=0.60). The NLR was significantly higher in patients with RMVS [2.9 (0.6-13.0) vs. 2.1 (0.7-5.8), p<0.001]. Besides, C-reactive protein (CRP) was also higher in the RMVS group [5.99 (0.3-23.7) vs. 2.98 (0.6-6.3), p=0.001]. In the regression analysis, NLR (OR: 2.24, p=0.04), CRP (OR: 1.34, p=0.03), and left atrial diameter (OR: 1.21, p=0.001) were independent predictors of RMVS. In the correlation analysis, there was a significant positive correlation between NLR and CRP (r=0.43, p<0.001).ConclusionWe found that NLR was significantly increased in RMVS. Furthermore, NLR was an independent predictor of the presence of RMVS in our study population. According to these findings, NLR can be used as a predictor of RMVS. Since it is an easily available and cheap method, it can easily be used in daily clinical practice. Increased NLR can also be a sign of ongoing chronic inflammation in patients with RMVS.

The neutrophil to lymphocyte ratio is associated with severity of rheumatic mitral valve stenosis

“…Although Akboğa et al found that NLR was significantly increased in patients with RMS than control groups, NLR did not reach statistical significance in MS groups. 23 On the other hand, in a recent study, it was shown that high NLR predicted presence and severity of MS in patients with rheumatic mitral valve disease. 24 However, Akboğa et al subdivided the RMS into mild-moderate and severe MS groups; we not only assessed mild, moderate and severe MS groups, but also reassessed mild and moderate-severe MS. Our study differs from the previous studies in that we evaluated the relationship between NLR and the degree of RMS.…”

Lymphocytopenia is associated with poor NYHA functional class in chronic heart failure patients with reduced ejection fraction

“…[18] Several studies have reported increased N/L ratio in rheumatic mitral valve stenosis and pulmonary artery hypertension, and it is associated with increased mortality in patients with acute coronary syndromes, HF, peripheral arterial disease, pulmonary embolism and infective endocarditis. [14][15][16][19][20][21][22][23][24] Furthermore, elevated N/L ratio is related to poor functional capacity in patients with HF. [25,26] In HF patients, neurohumoral activation, downregulation of proliferation and differentiation of lymphocytes and lymphocyte apoptosis have been suggested as underlying mechanisms for lymphocytopenia.…”

Can percutaneous mitral balloon valvuloplasty reduce ongoing inflammation in patients with rheumatic mitral stenosis?

“…In acute RF, there are inflammation and edema of the leaflets; it has been believed that the repeated episodes of the carditis associated with RF are responsible for chronic rheumatic valve disease, characterized by the deposition of fibrous tissue [4,14]. On the other hand, the role of continuous inflammation has strongly been put forward by different studies of inflammation markers [4,[8][9][10][11][14][15][16][17][18][19][20][21][22][23]].…”