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Sun H, Du Z, Zhang X, Gao S, Ji Z, Luo G, Pan S. Neutrophil extracellular traps promote proliferation of pulmonary smooth muscle cells mediated by CCDC25 in pulmonary arterial hypertension. Respir Res 2024; 25:183. [PMID: 38664728 PMCID: PMC11046914 DOI: 10.1186/s12931-024-02813-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Previous studies have indicated that neutrophil extracellular traps (NETs) play a pivotal role in pathogenesis of pulmonary arterial hypertension (PAH). However, the specific mechanism underlying the impact of NETs on pulmonary artery smooth muscle cells (PASMCs) has not been determined. The objective of this study was to elucidate underlying mechanisms through which NETs contribute to progression of PAH. METHODS Bioinformatics analysis was employed in this study to screen for potential molecules and mechanisms associated with occurrence and development of PAH. These findings were subsequently validated in human samples, coiled-coil domain containing 25 (CCDC25) knockdown PASMCs, as well as monocrotaline-induced PAH rat model. RESULTS NETs promoted proliferation of PASMCs, thereby facilitating pathogenesis of PAH. This phenomenon was mediated by the activation of transmembrane receptor CCDC25 on PASMCs, which subsequently activated ILK/β-parvin/RAC1 pathway. Consequently, cytoskeletal remodeling and phenotypic transformation occur in PASMCs. Furthermore, the level of NETs could serve as an indicator of PAH severity and as potential therapeutic target for alleviating PAH. CONCLUSION This study elucidated the involvement of NETs in pathogenesis of PAH through their influence on the function of PASMCs, thereby highlighting their potential as promising targets for the evaluation and treatment of PAH.
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Affiliation(s)
- Hongxiao Sun
- Heart Center, Women and Children's Hospital, Qingdao University, Qingdao, China
| | - Zhanhui Du
- Heart Center, Women and Children's Hospital, Qingdao University, Qingdao, China
| | - Xu Zhang
- Heart Center, Women and Children's Hospital, Qingdao University, Qingdao, China
| | - Shuai Gao
- Heart Center, Women and Children's Hospital, Qingdao University, Qingdao, China
| | - Zhixian Ji
- Heart Center, Women and Children's Hospital, Qingdao University, Qingdao, China
| | - Gang Luo
- Heart Center, Women and Children's Hospital, Qingdao University, Qingdao, China
| | - Silin Pan
- Heart Center, Women and Children's Hospital, Qingdao University, Qingdao, China.
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Li Y, Fu Y, Liu Y, Zhao D, Liu L, Bourouis S, Algarni AD, Zhong C, Wu P. An optimized machine learning method for predicting wogonin therapy for the treatment of pulmonary hypertension. Comput Biol Med 2023; 164:107293. [PMID: 37591162 DOI: 10.1016/j.compbiomed.2023.107293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 06/25/2023] [Accepted: 07/28/2023] [Indexed: 08/19/2023]
Abstract
Human health is at risk from pulmonary hypertension (PH), characterized by decreased pulmonary vascular resistance and constriction of the pulmonary vessels, resulting in right heart failure and dysfunction. Thus, preventing PH and monitoring its progression before treating it is vital. Wogonin, derived from the leaves of Scutellaria baicalensis Georgi, exhibits remarkable pharmacological activity. In this study, we examined the effectiveness of wogonin in mitigating the progression of PH in mice using right heart catheterization and hematoxylin-eosin (HE) staining. As an alternative to minimize the possibility of harming small animals, we present a scientifically effective feature selection method (BSCDWOA-KELM) that will allow us to develop a novel simpler noninvasive prediction method for wogonin in treating PH. In this method, we use the proposed enhanced whale optimizer (SCDWOA) in conjunction with the kernel extreme learning machine (KELM). Initially, we let SCDWOA perform global optimization experiments on the IEEE CEC2014 benchmark function set to verify its core advantages. Lastly, 12 public and PH datasets are examined for feature selection experiments using BSCDWOA-KELM. As shown in the experimental results for global optimization, the proposed SCDWOA has better convergence performance. Meanwhile, the proposed binary SCDWOA (BSCDWOA) significantly improves the ability of KELM to classify data. By utilizing the BSCDWOA-KELM, key indicators such as the Red blood cell (RBC), the Haemoglobin (HGB), the Lymphocyte percentage (LYM%), the Hematocrit (HCT), and the Red blood cell distribution width-size distribution (RDW-SD) can be efficiently screened in the Pulmonary hypertension dataset, and one of its most essential points is its accuracy of greater than 0.98. Consequently, the BSCDWOA-KELM introduced in this study can be used to predict wogonin therapy for treating pulmonary hypertension in a simple and noninvasive manner.
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Affiliation(s)
- Yupeng Li
- College of Computer Science and Technology, Changchun Normal University, Changchun, Jilin 130032, China.
| | - Yujie Fu
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
| | - Yining Liu
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
| | - Dong Zhao
- College of Computer Science and Technology, Changchun Normal University, Changchun, Jilin 130032, China.
| | - Lei Liu
- College of Computer Science, Sichuan University, Chengdu, Sichuan 610065, China.
| | - Sami Bourouis
- Department of Information Technology, College of Computers and Information Technology, Taif University, P.O.Box 11099, Taif 21944, Saudi Arabia.
| | - Abeer D Algarni
- Department of Information Technology, College of Computer and Information Sciences, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia.
| | - Chuyue Zhong
- The First Clinical College, Wenzhou Medical University, Wenzhou 325000, China.
| | - Peiliang Wu
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
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3
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Boucly A, Tu L, Guignabert C, Rhodes C, De Groote P, Prévot G, Bergot E, Bourdin A, Beurnier A, Roche A, Jevnikar M, Jaïs X, Montani D, Wilkins MR, Humbert M, Sitbon O, Savale L. Cytokines as prognostic biomarkers in pulmonary arterial hypertension. Eur Respir J 2023; 61:2201232. [PMID: 36549710 DOI: 10.1183/13993003.01232-2022] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 11/12/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Risk stratification and assessment of disease progression in patients with pulmonary arterial hypertension (PAH) are challenged by the lack of accurate disease-specific and prognostic biomarkers. To date, brain natriuretic peptide (BNP) and/or its N-terminal fragment (NT-proBNP) are the only markers for right ventricular dysfunction used in clinical practice, in association with echocardiographic and invasive haemodynamic variables to predict outcome in patients with PAH. METHODS This study was designed to identify an easily measurable biomarker panel in the serum of 80 well-phenotyped PAH patients with idiopathic, heritable or drug-induced PAH at baseline and at first follow-up. The prognostic value of identified cytokines of interest was secondly analysed in an external validation cohort of 125 PAH patients. RESULTS Among the 20 biomarkers studied with the multiplex Ella platform, we identified a three-biomarker panel composed of β-NGF, CXCL9 and TRAIL that were independently associated with prognosis both at the time of PAH diagnosis and at the first follow-up after initiation of PAH therapy. β-NGF and CXCL9 were predictors of death or transplantation, whereas high levels of TRAIL were associated with a better prognosis. Furthermore, the prognostic value of the three cytokines was more powerful for predicting survival than usual non-invasive variables (New York Heart Association Functional Class, 6-min walk distance and BNP/NT-proBNP). The results were validated in a fully independent external validation cohort. CONCLUSION The monitoring of β-NGF, CXCL9 and TRAIL levels in serum should be considered in the management and treatment of patients with PAH to objectively guide therapeutic options.
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Affiliation(s)
- Athénaïs Boucly
- INSERM UMR_S999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
- AP-HP, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Ly Tu
- INSERM UMR_S999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
| | - Christophe Guignabert
- INSERM UMR_S999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
| | | | - Pascal De Groote
- Université de Lille, Service de Cardiologie, CHU Lille, Institut Pasteur de Lille, Inserm U1167, Lille, France
| | - Grégoire Prévot
- CHU de Toulouse, Hôpital Larrey, Service de Pneumologie, Toulouse, France
| | - Emmanuel Bergot
- Unicaen, UFR Santé, Service de Pneumologie & Oncologie Thoracique, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Arnaud Bourdin
- PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR_9214, Montpellier, France
| | - Antoine Beurnier
- INSERM UMR_S999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
- AP-HP, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Anne Roche
- INSERM UMR_S999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
- AP-HP, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Mitja Jevnikar
- INSERM UMR_S999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
- AP-HP, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Xavier Jaïs
- INSERM UMR_S999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
- AP-HP, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - David Montani
- INSERM UMR_S999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
- AP-HP, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Martin R Wilkins
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Marc Humbert
- INSERM UMR_S999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
- AP-HP, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Olivier Sitbon
- INSERM UMR_S999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
- AP-HP, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- These authors contributed equally to this work
| | - Laurent Savale
- INSERM UMR_S999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
- AP-HP, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- These authors contributed equally to this work
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Hojda SE, Chis IC, Clichici S. Biomarkers in Pulmonary Arterial Hypertension. Diagnostics (Basel) 2022; 12:diagnostics12123033. [PMID: 36553040 PMCID: PMC9776459 DOI: 10.3390/diagnostics12123033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Pulmonary arterial hypertension (PAH) is a severe medical condition characterized by elevated pulmonary vascular resistance (PVR), right ventricular (RV) failure, and death in the absence of appropriate treatment. The progression and prognosis are strictly related to the etiology, biochemical parameters, and treatment response. The gold-standard test remains right-sided heart catheterization, but dynamic monitoring of systolic pressure in the pulmonary artery is performed using echocardiography. However, simple and easily accessible non-invasive assays are also required in order to monitor this pathology. In addition, research in this area is in continuous development. In recent years, more and more biomarkers have been studied and included in clinical guidelines. These biomarkers can be categorized based on their associations with inflammation, endothelial cell dysfunction, cardiac fibrosis, oxidative stress, and metabolic disorders. Moreover, biomarkers can be easily detected in blood and urine and correlated with disease severity, playing an important role in diagnosis, prognosis, and disease progression.
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Bilik MZ, Oylumlu M, Oylumlu M, Acun B, Arik B, Arslan B, Acet H, Polat N, Akil MA. Novel predictor of pulmonary arterial hypertension: Monocyte to HDL cholesterol ratio. Medicine (Baltimore) 2022; 101:e29973. [PMID: 36042653 PMCID: PMC9410685 DOI: 10.1097/md.0000000000029973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Monocyte to HDL cholesterol ratio (MHR), lymphocyte to monocyte ratio (LMR), and neutrophil to lymphocyte ratio (NLR) have been proposed as novel systemic inflammatory markers. The aim of this study was to explore the association between MHR, LMR and NLR with pulmonary arterial hypertension (PAH). The study is a single-center, retrospective Cross-sectional study. The study group consisted of 73 patients with PAH and the control group 77 participants without cardiac pathology as determined by echocardiography. On admission, blood sampling to calculate MHR, LMR, NLR, and detailed clinical data were obtained. According to the Pearson test, systolic pulmonary artery pressure (PAP) value Higher MHR, NLR and lower LMR that indicates an enhanced inflammation were significantly increased in patients with PAH when compared with controls. Compared to many other inflammatory markers, these markers are widely available. positively correlated with the MHR and NLR (r:.35, P < .001 and r:.33, P < .001, respectively), but negatively correlated with LMR (r: -.26, P = .001). After multivariate logistic regression analysis, MHR, LMR, and NLR remained as significant predictors of PAH (OR: 2.651, 95% CI: 1.227-5.755, P = .007; OR: 0.647, 95% CI:0.450-0.931, P = .005; OR: 1.350, 95% CI: 1.054-1.650 P = .030, respectively).
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Affiliation(s)
- Mehmet Zihni Bilik
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
- *Correspondence: Mehmet Zihni Bilik, Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey (e-mail: )
| | - Muhammed Oylumlu
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
| | - Mustafa Oylumlu
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
| | - Baris Acun
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
| | - Baran Arik
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
| | - Bayram Arslan
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
| | - Halit Acet
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
| | - Nihat Polat
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
| | - Mehmet Ata Akil
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
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Wang N, Guo Z, Gong X, Kang S, Cui Z, Yuan Y. A Nomogram for Predicting the Risk of Pulmonary Hypertension for Patients with Chronic Obstructive Pulmonary Disease. Int J Gen Med 2022; 15:5751-5762. [PMID: 35770051 PMCID: PMC9234502 DOI: 10.2147/ijgm.s363035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 06/14/2022] [Indexed: 12/29/2022] Open
Abstract
Background Pulmonary hypertension (PH) is a life-threatening complication of chronic obstructive pulmonary disease (COPD). Timely diagnosis of PH in COPD patients is vital to achieve proper treatment; however, there is no algorithm to identify those at high risk. We aimed to develop a predictive model for PH in patients with COPD that provides individualized risk estimates. Methods A total of 527 patients with COPD who were admitted to our hospital between May 2019 and December 2020 were retrospectively enrolled in this study. Using echocardiographic results as a standard, patients were stratified into a moderate- or high-PH probability group and a low-PH probability group. They were randomly grouped into either the training set (n = 368 patients) or validation set (n = 159 patients) in a ratio of 7:3. We utilized the least absolute shrinkage and selection operator (LASSO) regression model to select the feature variables. The characteristic variables selected in the LASSO regression were analyzed using multivariable logistic regression to construct the predictive model. The predictive model was displayed using a nomogram. We used the receiver operating characteristic curve, calibration curve, and clinical decision curve analysis (DCA) to evaluate model performance, and internal validation was assessed. Results The predictive factors included in the prediction model were Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage, emphysema, PaCO2, NT-pro-BNP, red blood cell (RBC) distribution width-standard deviation (RDW-SD), and neutrophil/lymphocyte ratio (NLR). The predictive model yielded an area under the curve (AUC) of 0.770 (95% confidence interval [CI], 0.719–0.820); in the internal validation, the AUC was 0.741 (95% CI, 0.659–0.823). The predictive model was well calibrated, and the DCA showed that the proposed nomogram had strong clinical applicability. Conclusion This study showed that a simple nomogram could be used to calculate the risk of PH in patients with COPD which can be useful for the individualized clinical management of COPD patients who may be occur with PH. Further studies need to be confirmed by larger sample sizes and validated in the stable COPD population.
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Affiliation(s)
- Ning Wang
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China
- Department of Respiratory and Critical Care Medicine, Hengshui People’s Hospital, Hengshui, People’s Republic of China
| | - Zhenjiang Guo
- Department of Gastrointestinal Surgery, Hengshui People’s Hospital, Hengshui, People’s Republic of China
| | - Xiaowei Gong
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China
| | - Shiwei Kang
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China
| | - Zhaobo Cui
- Department of Respiratory and Critical Care Medicine, Hengshui People’s Hospital, Hengshui, People’s Republic of China
| | - Yadong Yuan
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China
- Correspondence: Yadong Yuan, Department of Respiratory and Critical Care Medicine, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Shijiazhuang, Hebei, 050000, People’s Republic of China, Tel/Fax +86-311-66003989, Email
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Smits AJ, Botros L, Mol MA, Ziesemer KA, Wilkins MR, Vonk Noordegraaf A, Bogaard HJ, Aman J. A Systematic Review with Meta-analysis of Biomarkers for detection of Pulmonary Arterial Hypertension. ERJ Open Res 2022; 8:00009-2022. [PMID: 35651362 PMCID: PMC9149393 DOI: 10.1183/23120541.00009-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/04/2022] [Indexed: 11/20/2022] Open
Abstract
Rationale The blood is a rich source of potential biomarkers for the diagnosis of idiopathic and hereditary pulmonary arterial hypertension (iPAH and hPAH, referred to as “PAH”). While a lot of biomarkers have been identified for PAH, the clinical utility of these biomarkers often remains unclear. Here, we performed an unbiased meta-analysis of published biomarkers to identify biomarkers with the highest performance for detection of PAH. Methods A literature search (in PubMed, Embase.com, Clarivate Analytics/Web of Science Core Collection and Wiley/Cochrane Library) was performed up to 28 January 2021. Primary end points were blood biomarker levels in PAH versus asymptomatic controls or patients suspected of pulmonary hypertension (PH) with proven normal haemodynamic profiles. Results 149 articles were identified by the literature search. Meta-analysis of 26 biomarkers yielded 17 biomarkers that were differentially expressed in PAH and non-PH control subjects. Red cell distribution width, low density lipid-cholesterol, d-dimer, N-terminal prohormone of brain natriuretic protein (NT-proBNP), interleukin-6 (IL-6) and uric acid were biomarkers with the largest observed differences, largest sample sizes and a low risk of publication bias. Receiver operating characteristic curves and sensitivity/specificity analyses demonstrated that NT-proBNP had a high sensitivity, but low specificity for PAH. For the other biomarkers, insufficient data on diagnostic accuracy with receiver operating characteristic curves were available for meta-analysis. Conclusion This meta-analysis validates NT-proBNP as a biomarker with high sensitivity for PAH, albeit with low specificity. The majority of biomarkers evaluated in this meta-analysis lacked either external validation or data on diagnostic accuracy. Further validation studies are required as well as studies that test combinations of biomarkers to improve specificity. Meta-analysis of 26 biomarkers yielded 17 differentially expressed biomarkers in PAH. NT-proBNP had the highest diagnostic accuracy but had a low specificity for PAH. Other markers, including IL-6, RDW, LDL-c, D-dimer and UA, lacked clinical validation.https://bit.ly/3J4YAyC
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8
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Neutrophil-lymphocyte ratio as an independent predictor of survival in pulmonary arterial hypertension: An exploratory study. CJC Open 2021; 4:357-363. [PMID: 35495856 PMCID: PMC9039554 DOI: 10.1016/j.cjco.2021.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/25/2021] [Indexed: 12/19/2022] Open
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9
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Florentin J, Zhao J, Tai YY, Vasamsetti SB, O’Neil SP, Kumar R, Arunkumar A, Watson A, Sembrat J, Bullock GC, Sanders L, Kassa B, Rojas M, Graham BB, Chan SY, Dutta P. Interleukin-6 mediates neutrophil mobilization from bone marrow in pulmonary hypertension. Cell Mol Immunol 2021; 18:374-384. [PMID: 33420357 PMCID: PMC8027442 DOI: 10.1038/s41423-020-00608-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 11/21/2020] [Indexed: 01/29/2023] Open
Abstract
Myeloid cells, such as neutrophils, are produced in the bone marrow in high quantities and are important in the pathogenesis of vascular diseases such as pulmonary hypertension (PH). Although neutrophil recruitment into sites of inflammation has been well studied, the mechanisms of neutrophil egress from the bone marrow are not well understood. Using computational flow cytometry, we observed increased neutrophils in the lungs of patients and mice with PH. Moreover, we found elevated levels of IL-6 in the blood and lungs of patients and mice with PH. We observed that transgenic mice overexpressing Il-6 in the lungs displayed elevated neutrophil egress from the bone marrow and exaggerated neutrophil recruitment to the lungs, resulting in exacerbated pulmonary vascular remodeling, and dysfunctional hemodynamics. Mechanistically, we found that IL-6-induced neutrophil egress from the bone marrow was dependent on interferon regulatory factor 4 (IRF-4)-mediated CX3CR1 expression in neutrophils. Consequently, Cx3cr1 genetic deficiency in hematopoietic cells in Il-6-transgenic mice significantly reduced neutrophil egress from bone marrow and decreased neutrophil counts in the lungs, thus ameliorating pulmonary remodeling and hemodynamics. In summary, these findings define a novel mechanism of IL-6-induced neutrophil egress from the bone marrow and reveal a new therapeutic target to curtail neutrophil-mediated inflammation in pulmonary vascular disease.
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Affiliation(s)
- Jonathan Florentin
- grid.412689.00000 0001 0650 7433Center for Pulmonary Vascular Biology and Medicine, Pittsburgh Heart, Lung, Blood, and Vascular Medicine Institute, Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213 USA
| | - Jingsi Zhao
- grid.412689.00000 0001 0650 7433Center for Pulmonary Vascular Biology and Medicine, Pittsburgh Heart, Lung, Blood, and Vascular Medicine Institute, Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213 USA
| | - Yi-Yin Tai
- grid.412689.00000 0001 0650 7433Center for Pulmonary Vascular Biology and Medicine, Pittsburgh Heart, Lung, Blood, and Vascular Medicine Institute, Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213 USA
| | - Sathish Babu Vasamsetti
- grid.412689.00000 0001 0650 7433Center for Pulmonary Vascular Biology and Medicine, Pittsburgh Heart, Lung, Blood, and Vascular Medicine Institute, Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213 USA
| | - Scott P. O’Neil
- grid.412689.00000 0001 0650 7433Center for Pulmonary Vascular Biology and Medicine, Pittsburgh Heart, Lung, Blood, and Vascular Medicine Institute, Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213 USA
| | - Rahul Kumar
- grid.266102.10000 0001 2297 6811Division of Pulmonary and Critical Care Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, Building 100, 2nd floor, 1001 Potrero Ave, San Francisco, CA USA
| | - Anagha Arunkumar
- grid.412689.00000 0001 0650 7433Center for Pulmonary Vascular Biology and Medicine, Pittsburgh Heart, Lung, Blood, and Vascular Medicine Institute, Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213 USA
| | - Annie Watson
- grid.412689.00000 0001 0650 7433Center for Pulmonary Vascular Biology and Medicine, Pittsburgh Heart, Lung, Blood, and Vascular Medicine Institute, Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213 USA
| | - John Sembrat
- grid.412689.00000 0001 0650 7433Center for Pulmonary Vascular Biology and Medicine, Pittsburgh Heart, Lung, Blood, and Vascular Medicine Institute, Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213 USA ,grid.21925.3d0000 0004 1936 9000Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA 15261 USA
| | - Grant C. Bullock
- grid.412689.00000 0001 0650 7433Center for Pulmonary Vascular Biology and Medicine, Pittsburgh Heart, Lung, Blood, and Vascular Medicine Institute, Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213 USA ,grid.412689.00000 0001 0650 7433Division of Hematopathology, Pittsburgh Heart, Lung, Blood, and Vascular Medicine Institute University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213 USA
| | - Linda Sanders
- grid.430503.10000 0001 0703 675XDepartment of Medicine, Anschutz Medical Campus, Building RC2, 9th floor, 12700 E 19th Ave, Aurora, CO 80045 USA
| | - Biruk Kassa
- grid.266102.10000 0001 2297 6811Division of Pulmonary and Critical Care Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, Building 100, 2nd floor, 1001 Potrero Ave, San Francisco, CA USA
| | - Mauricio Rojas
- grid.412689.00000 0001 0650 7433Center for Pulmonary Vascular Biology and Medicine, Pittsburgh Heart, Lung, Blood, and Vascular Medicine Institute, Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213 USA ,grid.21925.3d0000 0004 1936 9000Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA 15261 USA
| | - Brian B. Graham
- grid.430503.10000 0001 0703 675XDepartment of Medicine, Anschutz Medical Campus, Building RC2, 9th floor, 12700 E 19th Ave, Aurora, CO 80045 USA
| | - Stephen Y. Chan
- grid.412689.00000 0001 0650 7433Center for Pulmonary Vascular Biology and Medicine, Pittsburgh Heart, Lung, Blood, and Vascular Medicine Institute, Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213 USA
| | - Partha Dutta
- grid.412689.00000 0001 0650 7433Center for Pulmonary Vascular Biology and Medicine, Pittsburgh Heart, Lung, Blood, and Vascular Medicine Institute, Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213 USA ,grid.21925.3d0000 0004 1936 9000Department of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213 USA
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Korkmaz C, Demircioglu S. The Association of Neutrophil/Lymphocyte and Platelet/Lymphocyte Ratios and Hematological Parameters with Diagnosis, Stages, Extrapulmonary Involvement, Pulmonary Hypertension, Response to Treatment, and Prognosis in Patients with Sarcoidosis. Can Respir J 2020; 2020:1696450. [PMID: 33062080 PMCID: PMC7555456 DOI: 10.1155/2020/1696450] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 09/16/2020] [Indexed: 12/17/2022] Open
Abstract
Sarcoidosis is a rare disease characterized by granulomatous inflammation in affected organs, primarily in lungs. Neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) are easy and practical methods providing valuable information in diagnosis, severity, and prognosis of various diseases. Here, we aimed to investigate the association between NLR, PLR, and hematological parameters in sarcoidosis. The study was performed with 75 sarcoidosis patients and 92 controls. Patients' NLR, PLR, and hematological parameters were compared with those of controls. Additionally, while differences between NLR and PLR were investigated in sarcoidosis patients, differences of extrapulmonary involvement, pulmonary hypertension (PH), and spontaneous remission between those with and without responses to treatment concerning stages were also assessed. NLR and PLR were significantly higher in sarcoidosis patients than controls. For NLR, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were found as 68, 61, 58, and 70% respectively, while sensitivity, specificity, PPV, and NPV for PLR were found as 72, 67, 63, and 74%, respectively. In sarcoidosis patients, NLR and PLR were significantly higher at stage-2 and -3 than at stage -1 and -4. There was a significant weak positive correlation between C-reactive protein (CRP) and NLR and PLR. Mean platelet volume (MPV), hemoglobin (Hgb), and mean corpuscular volume (MCV) were lower among patients than controls. A positive moderate correlation was detected between NLR and CD4/CD8 in blood, while there was a strong positive correlation between CD4/CD8 in bronchoalveolar lavage (BAL) and positive moderate correlation between PLR and CD4/CD8 in BAL. High NLR and PLR values were not significantly associated with pulmonary PH, spontaneous remission, response to treatment, and prognosis. The increase in PLR and NLR may be a guide for diagnoses of both sarcoidosis and lung parenchymal involvement. To use these entities as markers, our findings should be supported with prospective studies with larger samples.
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Affiliation(s)
- Celalettin Korkmaz
- Department of Chest Diseases, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Sinan Demircioglu
- Department of Internal Medicine, Division of Hematology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
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Predictive Value of Novel Inflammation-Based Biomarkers for Pulmonary Hypertension in the Acute Exacerbation of Chronic Obstructive Pulmonary Disease. Anal Cell Pathol (Amst) 2019; 2019:5189165. [PMID: 31737467 PMCID: PMC6815641 DOI: 10.1155/2019/5189165] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 09/06/2019] [Indexed: 12/14/2022] Open
Abstract
Recently, there has been an increasing interest in the potential clinical use of several inflammatory indexes, namely, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic-immune-inflammation index (SII). This study aimed at assessing whether these markers could be early indicators of pulmonary hypertension (PH) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). A total of 185 patients were enrolled in our retrospective study from January 2017 to January 2019. Receiver operating characteristic curve (ROC) and area under the curve (AUC) were used to evaluate the clinical significance of these biomarkers to predict PH in patients with AECOPD. According to the diagnostic criterion for PH by Doppler echocardiography, the patients were stratified into two groups. The study group consisted of 101 patients complicated with PH, and the control group had 84 patients. The NLR, PLR, and SII values of the PH group were significantly higher than those of the AECOPD one (p < 0.05). The blood biomarker levels were positively correlated with NT-proBNP levels, while they had no significant correlation with the estimated pulmonary arterial systolic pressure (PASP) other than PLR. NLR, PLR, and SII values were all associated with PH (p < 0.05) in the univariate analysis, but not in the multivariate analysis. The AUC of NLR used for predicting PH was 0.701 and was higher than PLR and SII. Using 4.659 as the cut-off value of NLR, the sensitivity was 81.2%, and the specificity was 59.5%. In conclusion, these simple markers may be useful in the prediction of PH in patients with AECOPD.
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Srinivasagopalane B, Andrew Rajarathinam S, Balasubramaiyan T. Clinical pertinence of neutrophil-to- lymphocyte ratio among hypertensives with different grades and duration of hypertension - an insight. Clin Exp Hypertens 2018; 41:394-399. [PMID: 30183451 DOI: 10.1080/10641963.2018.1510942] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Over the recent years, the pathophysiology of the inflammatory component in hypertension has been a challenge, because this inflammatory response is mainly contributed by an increased oxidative stress with the release of inflammatory mediators. Identification of a simple and early inflammatory marker such as the neutrophil-to-lymphocyte ratio (NLR) is the need of the hour. This study correlates the same specifically taking into account the duration and the grades of hypertension. OBJECTIVE The response of the NLR among the hypertensives and its correlation with duration and stages of hypertension. METHOD Totally, 80 subjects and 40 controls of age between 20 and 60 years and both genders were included. Three recordings of blood pressure were measured with a standard mercury sphygmomanometer. The differential leukocyte count was estimated with an automated Beckman Coulter. OBJECTIVE Variations in the neutrophil and lymphocyte counts were significant among the hypertensives with a p-value < 0.001. The NLR was also significantly altered among the hypertensives with a p-value = 0.001. The NLR showed a rise in value among the normotensives, prehypertensives, and stage 1 of systolic hypertension, though not statistically significant. An increase in the NLR was observed in hypertensives with duration of 1-2 years. CONCLUSION Our study gives a new insight with a rise in NLR in early years and even among prehypertensives and stage 1 systolic hypertension under strict criterion. This could be utilized as an early predictive tool, relating the inflammatory process and hypertension which on further intervention could slow the progression of the disease process. ABBREVIATIONS NLR: Neutrophil-to-lymphocyte ratio; BP: Blood pressure.
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Affiliation(s)
- Brinda Srinivasagopalane
- a Department of Physiology, Physiology , ACS Medical College and Hospital, Vellapanchavadi , Chennai , India
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Taylor S, Dirir O, Zamanian RT, Rabinovitch M, Thompson AAR. The Role of Neutrophils and Neutrophil Elastase in Pulmonary Arterial Hypertension. Front Med (Lausanne) 2018; 5:217. [PMID: 30131961 PMCID: PMC6090899 DOI: 10.3389/fmed.2018.00217] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 07/16/2018] [Indexed: 01/11/2023] Open
Abstract
Pulmonary arterial hypertension (PAH) is a severe vasculopathy characterized by the presence of fibrotic lesions in the arterial wall and the loss of small distal pulmonary arteries. The vasculopathy is accompanied by perivascular inflammation and increased protease levels, with neutrophil elastase notably implicated in aberrant vascular remodeling. However, the source of elevated elastase levels in PAH remains unclear. A major source of neutrophil elastase is the neutrophil, an understudied cell population in PAH. The principal function of neutrophils is to destroy invading pathogens by means of phagocytosis and NET formation, but proteases, chemokines, and cytokines implicated in PAH can be released by and/or prime and activate neutrophils. This review focuses on the contribution of inflammation to the development and progression of the disease, highlighting studies implicating neutrophils, neutrophil elastase, and other neutrophil proteases in PAH. The roles of cytokines, chemokines, and neutrophil elastase in the disease are discussed and we describe new insight into the role neutrophils potentially play in the pathogenesis of PAH.
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Affiliation(s)
- Shalina Taylor
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
- Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford University, Stanford, CA, United States
| | - Omar Dirir
- Infection, Immunity, and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Roham T. Zamanian
- Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford University, Stanford, CA, United States
- Division of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Marlene Rabinovitch
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
- Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford University, Stanford, CA, United States
| | - A. A. Roger Thompson
- Infection, Immunity, and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
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Neary JM, Church D, Reeves N, Rathmann RJ. Successful treatment of suckling Red Angus calves for bovine respiratory disease is not associated with increased mean pulmonary arterial pressures at weaning. J Anim Sci 2018; 96:3070-3076. [PMID: 29762738 PMCID: PMC6095343 DOI: 10.1093/jas/sky189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 05/07/2018] [Indexed: 11/14/2022] Open
Abstract
The purposes of this study were to determine if the successful treatment of bovine respiratory disease (BRD) in suckling calves was associated with a long-term increase in mean pulmonary arterial pressure (mPAP) and, to screen for associations between blood leukogram variables and mPAP. A cohort of Red Angus calves (n = 74) were followed from birth to weaning at an altitude of 975 m. Calves were weaned at 172 ± 14 d when their mPAP was measured and whole blood collected. Thirty calves that had been treated for BRD (34 to 45 d prior) and 30 calves that had not required treatment for BRD were sampled. Treatment for BRD had no effect on mPAP (P = 0.37). Mean mPAP was 48 ± 8 mm Hg (± SD) with a minimum of 34 mm Hg and a maximum at 69 mm Hg. Weaning weight and sex tended to be associated with mPAP, but they explained just 5% of the variation in mPAP (P = 0.08; Adj. r2 = 0.05). Fibrinogen (P = 0.008) and absolute lymphocyte count (P = 0.06) were negatively associated with mPAP, whereas absolute monocyte count was positively associated with mPAP (P = 0.01). The findings of this study suggest that pre-weaning treatment for BRD does not increase a calves' post-weaning risk of congestive right heart failure. Further, components of the immune and acute phase response system may play a role in the development and progression of pulmonary hypertension.
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Affiliation(s)
- Joseph M Neary
- Department of Animal and Food Sciences, College of Agricultural Sciences and Natural Resources, Texas Tech University, Lubbock, TX
| | - Dee Church
- Department of Animal and Food Sciences, College of Agricultural Sciences and Natural Resources, Texas Tech University, Lubbock, TX
| | - Nathan Reeves
- Department of Animal and Food Sciences, College of Agricultural Sciences and Natural Resources, Texas Tech University, Lubbock, TX
| | - Ryan J Rathmann
- Department of Animal and Food Sciences, College of Agricultural Sciences and Natural Resources, Texas Tech University, Lubbock, TX
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Bassareo PP, Fanos V, Pala M, Antonucci L, Neroni P, Antonucci R, Mercuro G. Supraventricular tachycardia during the first year of life: is subclinical inflammation the trigger? J Matern Fetal Neonatal Med 2016; 31:53-58. [PMID: 28006998 DOI: 10.1080/14767058.2016.1275545] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Neutrophil/lymphocyte ratio (NLR) and red cell distribution width (RDW) may be associated with the onset of arrhythmias in adults, thus underlining a possible inflammatory etiology. Paroxysmal supraventricular tachycardia (SVT) is the most frequent pathological tachycardia in childhood. AIM To verify NLR and RDW levels in a group of children (<1 year) affected by SVT with a structurally normal heart and without fever or inflammatory diseases; to compare NLR and RDW before and after SVT resolution, to verify whether the latter was related with the reduction in inflammatory state; to identify - in SVT subtypes caused by a reentry mechanism - an NLR and RDW cutoff point beyond which adenosine was ineffective in preventing SVT recurrence. METHODS Eighteen SVT patients were recruited (mean age 18.9 ± 3.2 days; 50% males) and compared with 18 healthy peers. RESULTS NLR was higher in SVT group than in controls (p < 0.03). A significant difference was revealed between NLR values obtained on admission and at discharge (p < 0.05). On the contrary, no significant differences were found for RDW. It was not possible to identify NLR or RDW cutoffs capable of predicting SVT recurrence. However, all patients featuring SVT recurrence following adenosine injection presented with a lymphocyte count >6000/mm3. CONCLUSIONS Elevated NLR is associated with an increased risk of SVT during the first year of life, while its decline looks like to lead the SVT resolution. A subclinical inflammatory status, as assessed by lymphocytes count, influences SVT recurrence. These results provide further support for an inflammatory etiology of SVT in babies.
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Affiliation(s)
- Pier Paolo Bassareo
- a Department of Medical Sciences "M. Aresu" , University of Cagliari , Cagliari , Italy
| | - Vassilios Fanos
- b Department of Pediatrics and Clinical Medicine, Section of Neonatal Intensive Care Unit , University of Cagliari , Cagliari , Italy
| | - Mario Pala
- c Pediatric Cardiology Unit , AOU Sassari , Sassari , Italy
| | - Luca Antonucci
- a Department of Medical Sciences "M. Aresu" , University of Cagliari , Cagliari , Italy
| | - Paola Neroni
- b Department of Pediatrics and Clinical Medicine, Section of Neonatal Intensive Care Unit , University of Cagliari , Cagliari , Italy
| | | | - Guseppe Mercuro
- a Department of Medical Sciences "M. Aresu" , University of Cagliari , Cagliari , Italy
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The Association between ESR and CRP and Systemic Hypertension in Sarcoidosis. Int J Hypertens 2016; 2016:2402515. [PMID: 27433355 PMCID: PMC4940541 DOI: 10.1155/2016/2402515] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 06/06/2016] [Indexed: 01/10/2023] Open
Abstract
Introduction. The association between the level of systemic inflammation and systemic hypertension (sHTN) among subjects with sarcoidosis has not been previously explored. Methods. A retrospective study was conducted to investigate the relation between the level of systemic inflammation in sarcoidosis, measured by various serum inflammatory markers, and sHTN. Results. Among a total of 108 cases with sarcoidosis (mean age: 53.4 years, 76.9% females), 55 (50.9%) had sHTN and 53 (49.1%) were normotensive. ESR was highly associated with sHTN. The patients with sHTN had higher mean ESR levels compared with normotensives (48.8 ± 35 versus 23.2 ± 27 mm/hr, resp.; P = 0.001). ROC curve analysis for ESR revealed an AUC value of 0.795 (95% CI: 0.692–0.897; P = 0.0001). With regard to CRP, there was a trend towards higher mean values in sHTN group (3.4 versus 1.7 mg/L; P = 0.067) and significantly higher prevalence of sHTN in the highest CRP quartile compared to the lowest one (69.6% versus 30%; OR 4.95; P = 0.017). ROC curve analysis for CRP revealed an AUC value of 0.644 (95% CI: 0.518–0.769; P = 0.03). On multivariate analysis, ESR and the CRP remained independent predictors for sHTN among subjects with sarcoidosis. Conclusion. Systemic inflammation is associated with the presence of sHTN in sarcoidosis.
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Hoffmann J, Wilhelm J, Olschewski A, Kwapiszewska G. Microarray analysis in pulmonary hypertension. Eur Respir J 2016; 48:229-41. [PMID: 27076594 PMCID: PMC5009873 DOI: 10.1183/13993003.02030-2015] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 02/15/2016] [Indexed: 12/21/2022]
Abstract
Microarrays are a powerful and effective tool that allows the detection of genome-wide gene expression differences between controls and disease conditions. They have been broadly applied to investigate the pathobiology of diverse forms of pulmonary hypertension, namely group 1, including patients with idiopathic pulmonary arterial hypertension, and group 3, including pulmonary hypertension associated with chronic lung diseases such as chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis. To date, numerous human microarray studies have been conducted to analyse global (lung homogenate samples), compartment-specific (laser capture microdissection), cell type-specific (isolated primary cells) and circulating cell (peripheral blood) expression profiles. Combined, they provide important information on development, progression and the end-stage disease. In the future, system biology approaches, expression of noncoding RNAs that regulate coding RNAs, and direct comparison between animal models and human disease might be of importance. Comprehensive overview of compartment-specific microarray studies of material from pulmonary hypertension patientshttp://ow.ly/YEFO2
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Affiliation(s)
- Julia Hoffmann
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
| | - Jochen Wilhelm
- Dept of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center, German Center for Lung Research, Giessen, Germany
| | - Andrea Olschewski
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria Dept of Experimental Anaesthesiology, Medical University of Graz, Graz, Austria
| | - Grazyna Kwapiszewska
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria Dept of Experimental Anaesthesiology, Medical University of Graz, Graz, Austria
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18
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Soylu K, Gedikli Ö, Ekşi A, Avcıoğlu Y, Soylu Aİ, Yüksel S, Aksan G, Gülel O, Yılmaz Ö. Neutrophil-to-lymphocyte ratio for the assessment of hospital mortality in patients with acute pulmonary embolism. Arch Med Sci 2016; 12:95-100. [PMID: 26925123 PMCID: PMC4754370 DOI: 10.5114/aoms.2016.57585] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 05/25/2014] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Neutrophil-to-lymphocyte ratio (NLR), which is an essential marker of inflammation, has been shown to be associated with adverse outcomes in various cardiovascular diseases in the literature. In this study we sought to evaluate the association between NLR and prognosis of acute pulmonary embolism (APE). MATERIAL AND METHODS We retrospectively evaluated blood counts and clinical data of 142 patients with the diagnosis of pulmonary embolism (PE) from Ondokuz Mayis University Hospital between January 2006 and December 2012. The patients were divided into two groups according to NLR: NLR < 4.4 (low NLR group, n = 71) and NLR ≥ 4.4 (high NLR group, n = 71). RESULTS Massive embolism (66.2% vs. 36.6%, p < 0.001) and in-hospital mortality (21.1%, 1.4%, p < 0.001) were higher in the high NLR group. In multivariate regression analysis NLR ≥ 5.7, systolic blood pressure (BP) < 90 mm Hg, serum glucose > 126 mg/dl, heart rate > 110 beats/min, and PCO2 < 35 or > 50 mm Hg were predictors of in-hospital mortality. The optimal NLR cutoff value was 5.7 for mortality in receiver operating characteristic (ROC) analysis. Having an NLR value above 5.7 was found to be associated with a 10.8 times higher mortality rate than an NLR value below 5.7. CONCLUSIONS In patients presenting with APE, NLR value is an independent predictor of in-hospital mortality and may be used for clinical risk classification.
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Affiliation(s)
- Korhan Soylu
- Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Ömer Gedikli
- Department of Cardiology, Artvin State Hospital, Artvin, Turkey
| | - Alay Ekşi
- Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Yonca Avcıoğlu
- Department of Cardiology, Düzen Laboratories Group, Ankara, Turkey
| | - Ayşegül İdil Soylu
- Department of Radiology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Serkan Yüksel
- Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Gökhan Aksan
- Department of Cardiology, Gazi State Hospital, Samsun, Turkey
| | - Okan Gülel
- Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Özcan Yılmaz
- Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
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Aydın M, Yıldız A, Yüksel M, Polat N, Aktan A, İslamoğlu Y. Assessment of the neutrophil/lymphocyte ratio in patients with supraventricular tachycardia. Anatol J Cardiol 2016; 16:29-33. [PMID: 26467360 PMCID: PMC5336702 DOI: 10.5152/akd.2015.5927] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The neutrophil/lymphocyte ratio (NLR) has been evaluated as a new predictor of cardiovascular risk. Inflammation has been shown to be associated with various arrhythmias including supraventricular tachycardias (SVTs). In this study, we aimed to investigate the relation between NLR and SVT in patients with a documented atrial tachyarrhythmia. METHODS The study used a retrospective cross-sectional design. Patients who had SVT but were otherwise healthy were included. The exclusion criteria included drug use (except antiarrhythmic agents), morbid obesity, acute or chronic infection, inflammatory diseases, systemic diseases, and cancer. Total and differential leukocyte counts and routine biochemical tests were performed before the ablation procedure. RESULTS The study included 150 patients with SVT and 98 healthy controls. The biochemical and hematological parameters were comparable between the groups, except neutrophil and lymphocyte counts. The neutrophil count was significantly higher (4.7±1.5x103/µL versus 4.1±1.0x103/µL; p<0.001) and lymphocyte count was significantly lower (2.2±0.6x103/µL versus 2.5±0.6x103/µL; p=0.001) in the SVT group than in the control group. As a result, the SVT group had significantly higher NLR values than the control group (2.2±0.9 versus 1.7±0.5; p<0.001). In addition, NLR values were higher in patients in whom tachycardia was induced during an electrophysiological study (EPS) (2.3±0.9 versus 2.0±0.8; p=0.02). The association between NLR and SVT remained significant after multivariate analysis (odds ratio: 1.5, 95% confidence interval: 1.001-2.263, p=0.049). CONCLUSION Our study indicated that NLR values were significantly higher in patients with documented SVT than in control subjects. Inducibility of SVT during EPS was associated with higher NLR values.
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Affiliation(s)
- Mesut Aydın
- Department of Cardiology, Faculty of Medicine, Dicle University; Diyarbakır-Turkey.
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Durmus E, Kivrak T, Gerin F, Sunbul M, Sari I, Erdogan O. Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio are Predictors of Heart Failure. Arq Bras Cardiol 2015; 105:606-13. [PMID: 26536980 PMCID: PMC4693665 DOI: 10.5935/abc.20150126] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 07/27/2015] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are inflammatory markers used as prognostic factors in various diseases. The aims of this study were to compare the PLR and the NLR of heart failure (HF) patients with those of age-sex matched controls, to evaluate the predictive value of those markers in detecting HF, and to demonstrate the effect of NLR and PLR on mortality in HF patients during follow-up. METHODS This study included 56 HF patients and 40 controls without HF. All subjects underwent transthoracic echocardiography to evaluate cardiac functions. The NLR and the PLR were calculated as the ratio of neutrophil count to lymphocyte count and as the ratio of platelet count to lymphocyte count, respectively. All HF patients were followed after their discharge from the hospital to evaluate mortality, cerebrovascular events, and re-hospitalization. RESULTS The NLR and the PLR of HF patients were significantly higher compared to those of the controls (p < 0.01). There was an inverse correlation between the NLR and the left ventricular ejection fraction of the study population (r: -0.409, p < 0.001). The best cut-off value of NLR to predict HF was 3.0, with 86.3% sensitivity and 77.5% specificity, and the best cut-off value of PLR to predict HF was 137.3, with 70% sensitivity and 60% specificity. Only NLR was an independent predictor of mortality in HF patients. A cut-off value of 5.1 for NLR can predict death in HF patients with 75% sensitivity and 62% specificity during a 12.8-month follow-up period on average. CONCLUSION NLR and PLR were higher in HF patients than in age-sex matched controls. However, NLR and PLR were not sufficient to establish a diagnosis of HF. NLR can be used to predict mortality during the follow-up of HF patients.
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Affiliation(s)
- Erdal Durmus
- Cardiology Clinic, Silifke State Hospital, Mersin, Turkey
| | - Tarik Kivrak
- Cardiology Clinic, Sivas Numune Hospital, Sivas, Turkey
| | - Fethullah Gerin
- Department of Clinical Biochemistry, Central Laboratory of Public Health, Istanbul, Turkey
| | - Murat Sunbul
- Department of Cardiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Ibrahim Sari
- Department of Cardiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Okan Erdogan
- Department of Cardiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
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Polat O, Yavaş GF, İnan S, İnan ÜÜ. Neutrophil-to-Lymphocyte Ratio as a Marker in Patients with Non-arteritic Anterior Ischemic Optic Neuropathy. Balkan Med J 2015; 32:382-7. [PMID: 26740898 DOI: 10.5152/balkanmedj.2015.15689] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Accepted: 09/03/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Non-arteritic anterior ischemic optic neuropathy (NAION) is the most common acute optic neuropathy in patients over the age of 50 and is the second most common cause of permanent optic nerve-related visual loss in adults after glaucoma. Although the precise cause of NAION remains elusive, the etiology of NAION is believed to be multifactorial. AIMS To evaluate the utility of neutrophil-to-lymphocyte ratio (NLR) as a simple and readily available prognostic factor for clinical disease activity in patients with NAION. STUDY DESIGN Case-control study. METHODS Forty-five patients with the diagnosis of NAION and 50 age- and sex-matched controls with/without any systemic or ocular diseases except cataract were retrospectively enrolled in the study. Demographic characteristics and laboratory findings including complete blood count of all patients and control subjects were obtained from the electronic medical record. The neutrophil and lymphocyte counts were recorded and the NLR was calculated. RESULTS White blood cell, neutrophil, NLR and platelet values of the NAION patients were significantly higher than those of the controls (p<0.001, p<0.001, p=0.004, p=0.037, respectively). Initial NLR values were negatively correlated with initial and the third month best corrected visual acuity levels in the study group. The optimum NLR cut-off point for NAION was 1.94. CONCLUSION NLR could be considered as a new inflammatory marker for assessment of the severity of inflammation in NAION patients with its quick, cheap, easily measurable property with routine complete blood count analysis.
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Affiliation(s)
- Onur Polat
- Department of Ophthalmology, Afyon Kocatepe University Faculty of Medicine, Afyonkarahisar, Turkey
| | - Güliz Fatma Yavaş
- Department of Ophthalmology, Afyon Kocatepe University Faculty of Medicine, Afyonkarahisar, Turkey
| | - Sibel İnan
- Department of Ophthalmology, Afyon Kocatepe University Faculty of Medicine, Afyonkarahisar, Turkey
| | - Ümit Übeyt İnan
- Department of Ophthalmology, Afyon Kocatepe University Faculty of Medicine, Afyonkarahisar, Turkey
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Özpelit E, Akdeniz B, Özpelit ME, Tas S, Bozkurt S, Tertemiz KC, Sevinç C, Badak Ö. Prognostic value of neutrophil-to-lymphocyte ratio in pulmonary arterial hypertension. J Int Med Res 2015; 43:661-71. [PMID: 26347546 DOI: 10.1177/0300060515589394] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 05/02/2015] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To evaluate the prognostic value of baseline neutrophil-to-lymphocyte ratio (NLR) in the prediction of long-term mortality in patients with pulmonary arterial hypertension (PAH). METHODS This prospective study recorded NLR during initial diagnostic right-sided cardiac catheterization in adult patients with PAH. Demographic, clinical, laboratory and haemodynamic variables were compared by NLR tertile. Univariate and multivariate Cox regression analyses were used to determine whether NLR was independently associated with mortality. RESULTS Adults with PAH (n = 101) were followed-up for mean ± SD 36.8 ± 23.6 months. The number of deaths, New York Heart Association functional capacity (NYHA FC), levels of brain natriuretic peptide (BNP) or C-reactive protein (CRP) and presence of pericardial effusion increased as the NLR tertile increased, but haemoglobin and tricuspid plane annular systolic excursion (TAPSE) decreased. On univariate analysis, high NLR values were associated with mortality, but on multivariate analysis, NLR did not remain an independent predictor of mortality. Baseline NYHA FC, TAPSE, BNP level and pericardial effusion were independent predictors of mortality. CONCLUSIONS NLR was correlated with important prognostic markers in PAH such as NYHA FC, BNP and TAPSE. This simple marker may be useful in the assessment of disease severity in patients with PAH.
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Affiliation(s)
- Ebru Özpelit
- Department of Cardiology, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Bahri Akdeniz
- Department of Cardiology, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Mehmet Emre Özpelit
- Department of Cardiology, School of Medicine, Medical Park Hospital, Izmir University, Izmir, Turkey
| | - Sedat Tas
- Department of Cardiology, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Selen Bozkurt
- Department of Biostatistics and Medical Informatics, School of Medicine, Akdeniz University, Izmir, Turkey
| | - Kemal Can Tertemiz
- Department of Pulmonary Medicine, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Can Sevinç
- Department of Pulmonary Medicine, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Özer Badak
- Department of Cardiology, School of Medicine, Dokuz Eylul University, Izmir, Turkey
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Chen L, Lou Y, Chen Y, Yang J. Prognostic value of the neutrophil-to-lymphocyte ratio in patients with acute-on-chronic liver failure. Int J Clin Pract 2014; 68:1034-40. [PMID: 24666824 DOI: 10.1111/ijcp.12408] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES The neutrophil-to-lymphocyte ratio (NLR) is a novel inflammation index that has been shown to independently predict poor clinical outcomes. We aimed to evaluate the role of NLR in the prediction of 3-month mortality in patients with acute-on-chronic liver failure (AoCLF). METHODS One hundred and twenty-seven patients, including 46 patients with chronic hepatitis B (CHB), 81 with AoCLF and 58 healthy controls (HCs), were enrolled in the study. All patients were followed up for 4 months. The primary end-point was in-hospital mortality at the end of 90 days. A blood sample was collected for all subjects at admission to examine liver function, renal function, international normalised ratio, C-reactive protein and neutrophil and lymphocyte counts, and NLRs were calculated. A total of six clinical chemistry and biochemical variables were analysed for potential associations with outcomes using Cox proportional hazards and multiple regression models. RESULTS Acute-on-chronic liver failure patients had significantly higher NLRs on admission compared with HCs and CHB patients (all p = 0.001). Patients with elevated NLRs were associated with increased severity of liver disease and 3-month mortality rates. According to multivariate analysis, only NLR was an independent predictor for mortality (p = 0.025). CONCLUSIONS The NLR measured at admission can serve as an independent predictor for 3-month mortality rate in AoCLF patients.
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Affiliation(s)
- L Chen
- Department of Colorectal Surgery, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Zhejiang, China
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Yüksel M, Yıldız A, Oylumlu M, Akyüz A, Aydın M, Kaya H, Acet H, Polat N, Bilik MZ, Alan S. The association between platelet/lymphocyte ratio and coronary artery disease severity. Anatol J Cardiol 2014; 15:640-7. [PMID: 25550173 PMCID: PMC5336865 DOI: 10.5152/akd.2014.5565] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE In this study, we aimed to explore the association between platelet-to-lymphocyte ratio (PLR) and the severity of atherosclerosis in coronary artery disease (CAD). METHODS Clinical and laboratory data of 388 patients who underwent coronary angiography were evaluated retrospectively. Gensini score, which indicates the severity of atherosclerosis, was calculated for all of the patients. Patients with CAD were categorized as mild and severe atherosclerosis, according to their Gensini score. Eighty patients with normal coronary arteries formed the control group. Mean PLR values of the three study groups were compared. Also, PLR value was tested for whether it showed a positive correlation with Gensini score. RESULTS The mean PLR of the severe atherosclerosis group was significantly higher than that of the mild atherosclerosis and controls groups (p<0.001). Also, PLR was positively correlated with Gensini score in CAD patients. A cut-off value of 111 for PLR predicted severe atherosclerosis with 61% sensitivity and 59% specificity. Pre-procedural PLR level was found to be independently associated with Gensini score, together with WBC, age, and low HDL level, in the multivariate analysis. CONCLUSION Our study suggests that high PLR appears to be additive to conventional risk factors and commonly used biomarkers in predicting severe atherosclerosis.
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Affiliation(s)
- Murat Yüksel
- Department of Cardiology, Faculty of Medicine, Dicle University; Diyarbakır-Turkey.
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25
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Oylumlu M, Yıldız A, Oylumlu M, Yüksel M, Polat N, Bilik MZ, Akyüz A, Aydın M, Acet H, Soydinç S. Platelet-to-lymphocyte ratio is a predictor of in-hospital mortality patients with acute coronary syndrome. Anatol J Cardiol 2014; 15:277-83. [PMID: 25413224 PMCID: PMC5336835 DOI: 10.5152/akd.2014.5366] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objective: Platelets and inflammatory cells are vital elements of acute coronary syndromes (ACS). Recent studies have shown that the plateletto-lymphocyte ratio (PLR) is associated with several malignancies; however, there are not enough data in cardiovascular diseases. Therefore, the aim of this study was to explore the association between PLR and in-hospital mortality in patients with ACS. Methods: We retrospectively collected patients with ACS undergoing coronary angiography. Total and differential leukocyte counts were measured by an automated hematology analyzer. Results: This study is single-centered and observational. In total, 587 patients with a mean age of 61.8±13.1 years (68.4% male) were enrolled in the study. Patients were divided into 3 tertiles based on PLR levels. In-hospital mortality was significantly higher among patients in the upper PLR tertile when compared with the middle and lower PLR tertile groups [29 (14.8%) vs. 17 (8.7%) and 2 (1.0%); p<0.001]. In the multiple logistic regression analysis, a high level of PLR was an independent predictor of in-hospital mortality, together with age, total leukocyte count, and creatinine. Using a cutoff point of 142, the PLR predicted in-hospital mortality with a sensitivity of 69% and specificity of 63%. Conclusion: Different from other inflammatory markers and assays, PLR is an inexpensive and readily available biomarker that may be useful for cardiac risk stratification in patients with ACS.
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Affiliation(s)
- Mustafa Oylumlu
- Department of Cardiology, Faculty of Medicine, Dicle University; Diyarbakır-Turkey.
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Polat N, Yildiz A, Yuksel M, Bilik MZ, Aydin M, Acet H, Akil MA, Oylumlu M, Kaya H, Ertas F, Cil H. Association of Neutrophil–Lymphocyte Ratio With the Presence and Severity of Rheumatic Mitral Valve Stenosis. Clin Appl Thromb Hemost 2013; 20:793-8. [DOI: 10.1177/1076029613514131] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of the study is to investigate the association between the severity of rheumatic mitral valvular disease (RMVD) and the neutrophil–lymphocyte ratio (NLR). A total of 227 patients were enrolled in the study and divided into 3 groups. Patients in group 1 had rheumatic mitral stenosis (RMS), those in group 2 had RMVD without stenosis, and those in group 3 served as the control group. Group 1 was further divided into 2 groups, severe mitral stenosis (MS) and mild to moderate MS. The NLR was significantly higher in patients with severe MS when compared to those with mild to moderate MS ( P = .002) while lymphocyte count was lower ( P = .034). Using a cutoff level of 2.56, the NLR predicted severe RMS with a sensitivity of 75% and specificity of 74%. In conclusion, as an inexpensive, simple, and accessible marker of inflammation, the NLR may be useful in predicting the presence and severity of MS in patients with RMVD.
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Affiliation(s)
- Nihat Polat
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Abdulkadir Yildiz
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Murat Yuksel
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Mehmet Zihni Bilik
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Mesut Aydin
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Halit Acet
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Mehmet Ata Akil
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Mustafa Oylumlu
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Hasan Kaya
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Faruk Ertas
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Habib Cil
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
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Yildiz A, Oylumlu M, Yuksel M, Aydin M, Polat N, Acet H, Akil MA, Bilik MZ, Kaya H, Ertas F. The Association Between the Neutrophil-to-Lymphocyte Ratio and the Presence of Ventricular Premature Contractions in Young Adults. Clin Appl Thromb Hemost 2013; 21:475-9. [PMID: 24203349 DOI: 10.1177/1076029613509478] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Inflammation has recently emerged in the pathogenesis of several cardiovascular disorders, including arrhythmias. The neutrophil-lymphocyte ratio (NLR) is a simple marker for the assessment of inflammatory status. Therefore, we aimed to investigate the relationship between the NLR and the ventricular premature contraction (VPC) existence. Patients aged between 18 and 40 years who were referred to the cardiology clinic were enrolled in the study. All patients' complete blood counts and 24-hour Holter recordings were analyzed. The NLR was higher within the VPC group compared to the control group (P < .001). According to the NLR tertiles, VPCs were more common in the higher NLR tertile (P < .001). A cutoff point of 1.80 for the NLR had 71% sensitivity and 60% specificity in predicting VPC in apparently healthy individuals. After multivariate analysis, only the NLR remained significant predictor of presence of VPC. In conclusion, the NLR is independently and significantly associated with VPC existence.
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Affiliation(s)
- Abdulkadir Yildiz
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Mustafa Oylumlu
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Murat Yuksel
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Mesut Aydin
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Nihat Polat
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Halit Acet
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Mehmet Ata Akil
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Mehmet Zihni Bilik
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Hasan Kaya
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Faruk Ertas
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
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