Relationship between haemodynamic indicators and haemogram in patients with heart failure

Abstract

Aims Pulmonary congestion, reduced cardiac output, neurohumoral factor activation, and decreased renal function associated with decreased cardiac function may have various effects on haemograms. The relationship between these factors and haemograms in patients with heart failure has not been sufficiently investigated. Recently, it was suggested that the lungs are an important site for platelet (Plt) biosynthesis and that it is necessary to study the relationship between pulmonary congestion and Plt count in heart failure in detail. In this study, we examined the relationship between various haemodynamic indicators and haemograms in detail using statistical analyses. Methods and results A total of 345 patients who underwent cardiac catheterization for the evaluation of cardiac function between 1 January 2015 and 31 December 2020 were included in the study. Haemodynamic indices, including left ventricular end‐diastolic pressure (LVEDP) and cardiac index (CI), were measured. Plasma noradrenaline (Nor) concentration, estimated glomerular filtration rate (eGFR), white blood cell (WBC) count, haemoglobin (Hb) level, and Plt count were measured using blood samples collected at the same time. Structural equation modelling (SEM) was used to examine the relationship between LVEDP, CI, plasma Nor concentration, eGFR, WBC count, Hb level, and Plt count. Bayesian inference using SEM was performed for Plt count. A total of 345 patients (mean age: 66.0 ± 13.2 years) were included in this study, and 251 (73%) patients were men. After simple and multiple regression analyses, path diagrams were drawn and analysed using SEM. LVEDP showed a significant negative relationship with Plt count (standardized estimate: −0.129, P = 0.015), and CI showed a significant negative relationship with Hb level (standardized estimate: −0.263, P < 0.001). Plasma Nor concentration showed a significant positive relationship with WBC count (standardized estimate: 0.165, P = 0.003) and Plt count (standardized estimate: 0.198, P < 0.001). The eGFR had a significant positive relationship with Hb level (standardized estimate: 0.274, P < 0.001). Bayesian inference using SEM revealed no relationship between LVEDP and Hb level or WBC count but a significant negative relationship between LVEDP and Plt count. Conclusions LVEDP, CI, plasma Nor concentration, and eGFR were related to WBC count, Hb level, and Plt count in patients with heart failure. There was a strong relationship between elevated LVEDP and decreased Plt count, suggesting that pressure overload on the lungs may interfere with the function of the lung as a site of Plt biosynthesis.

Predictive model for severe thrombocytopenia after transfemoral transcatheter aortic valve replacement

“…Although we tried to use LVEF and NT-proBNP to more objectively reflect the cardiac function and evaluate the effect of deterioration of cardiac function on STP, the results showed that NYHAFC IV had a more positive effect. We have not found relevant studies describing the mechanism of STP after TAVR in patients with heart failure, and recent studies have shown a strong correlation between left ventricular end-diastolic pressure increase and platelet count decrease in patients with heart failure, suggesting that pressure overload of the lung may interfere with the function of the lung as a site of platelet biosynthesis ( 24 ).…”

Contractility, ventriculoarterial coupling, and stroke work after acute myocardial infarction using CMR‐derived pressure‐volume loop data

“…The end diastolic pressure was set to 5 mmHg for the entire study population as per the original publication 4 . The range is thought to represent the majority of the study population of which no one suffered severe heart failure, considering that most patients with heart failure maintain a LV end‐diastolic pressure of 5−20 mmHg, and considering that differences in LV diastolic pressures, within reasonable ranges, have little effect on the calculated PV‐loop parameters 14,15 . Brachial sphygmomanometry data was gathered from the CHILL‐MI study result sheets, from the healthy control data sheets, and from clinical patient charts (SOCCER and MITOCARE) in accordance with informed consent.…”

Effect of heart rate on B-type natriuretic peptide in sinus rhythm

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