JCCVS
Journal of Cardiology & Cardiovascular Surgery

Journal of Cardiology & Cardiovascular Surgery scientific, open-access, double-blind peer-reviewed journal covering a wide spectrum of topics in cardiology and cardiovascular surgery.

eISSN: 2980-1397
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Original Article
The relationship between neutrophil to lymphocyte ratio and diastolic dysfunction in patients with essential hypertension
Abstract
Aim: Diastolic dysfunction (DD), which often accompanies essential hypertension (HT), can progress to heart failure with preserved ejection fraction. Recent studies have shown an association between chronic inflammation and HT. In this study, we aimed to investigate the neutrophil lymphocyte ratio (NLR) in hypertensive patients with and without DD and the relationship between NLR and DD development. Methods: The study included 50 patients with DD and 50 patients without DD. Left ventricular systolic and diastolic functions were evaluated by echocardiography in all patients. A complete blood count, C-reactive protein (CRP), and NLR were analyzed in blood samples obtained from the patients. Results: There was no significant difference in demographic characteristics and biochemical values between the two groups. White blood cell count and NLR were significantly higher in the group with DD (p<0.001). There was a strong correlation between the presence of DD and NLR in hypertensive patients (r=0.814, p<0.001). Although CRP was between reference values in both groups, it was significantly higher in the group with DD compared to the group without DD (4.40±1.60 vs. 3.70±0.90, p=0.020). Conclusion: NLR can be used to detect DD in patients with hypertension and is an easily accessible and inexpensive inflammatory marker.

Keywords : Hypertension, diastolic dysfunction, neutrophil/lymphocyte ratio.

Download Article


1. Vasan RS, Benjamin EJ, Levy D. Prevalance, clinical features andprognosis of diastolic heart failure: an epidemiologic perspective. J AmColl Cardiol 1995;26(7):1565-1574.
2. Vasan RS, Larson MG, Benjamin EJ, Evans JC, Reiss CK, Levy D.Congestive heart failure in subjects with normal versus reduced leftventricular ejection fraction: prevalence and mortality in a population-based cohort. J Am Coll Cardiol. 1999;33(7):1948-1955. doi:10.1016/s0735-1097(99)00118-7
3. Anker SD, von Haehling S. Inflammatory mediators in chronicheart failure: an overview. Heart. 2004;90(4):464-470. doi:10.1136/hrt.2002.007005
4. Mann DL. Inflammatory mediators and the failing heart: past, present,and the foreseeable future.Circ Res. 2002;91(11):988-998. doi:10.1161/01.res.0000043825.01705.1b
5. Aukrust P, Ueland T, M&uuml;ller F, Andreassen AK, Nordoy I, Aas H,et al. Elevated circulating levels of C-C chemokines in patientswith congestive heart failure. Circulation. 1998;97(12):1136-1143.doi:10.1161/01.cir.97.12.1136
6. Deswal A, Petersen NJ, Feldman AM, Young JB, White BG, MannDL. Cytokines and cytokine receptors in advanced heart failure: ananalysis of the cytokine database from the Vesnarinone trial (VEST).Circulation. 2001;103(16):2055-2059. doi:10.1161/01.cir.103.16.2055
7. Gibson PH, Cuthbertson BH, Croal BL, Rae D, El-Shafei H, Gibson G,et al. Usefulness of neutrophil/lymphocyte ratio as predictor of new-onset atrial fibrillation after coronary artery bypass grafting. Am JCardiol. 2010;105(2):186-191.
8. Christopher PA. Diastolic heart function. In: Murphy JG, Lloyd MA(eds), Mayo Clinic Cardioloji Concise Textbook (third ed.) Mayo ClinicScientific Pres. 2008: 1087-8.
9. Lekakis JP, Papathanassiou S, Papaioannou TG, et al. Oral L-arginineimproves endothelial dysfunction in patients with essentialhypertension.Int J Cardiol. 2002;86(2-3):317-323. doi:10.1016/s0167-5273(02)00413-8
10. Burnett JC Jr. Coronary endothelial dysfunction in the hypertensivepatient: from myocardial ischemia to heart failure. J Hum Hypertens1997;11(1):45-49.
11. Pagano PJ, Clark JK, Cifuentes-Pagano ME, Clark SM, Callis GM,Quinn MT. Localization of a constitutively active phagocyte-like NADPH oxidase in rabbit aortic adventitia: enhancement byangiotensin II. Proc Natl Acad Sci USA. 1997;94(26):14483-8.
12. Papa A, Emdin M, Passino C, Michelassi C, Battaglia D, Cocci F.Predictive value of elevated neutrophil-lymphocyte ratio on cardiacmortality in patients with stable coronary artery disease.Clin ChimActa 2008;395(1-2): 27-31.
13. Gaasch WH, Zile MR. Left ventricular diastolic dysfunction anddiastolic heart failure. Annu Rev Med. 2004;55:373-94.
14. Nicoletti A, Michel JB. Cardiac fibrosis and inflammation: interactionwith hemodynamic and hormonal factors. Cardiovasc Res. 1999;41(3):532-43.
15. Siwik DA, Colucci WS. Regulation of matrix metalloproteinases bycytokines and reactive oxygen/nitrogen species in the myocardium.Heart Fail Rev. 2004;9(1):43-51.
16. Yambe M, Tomiyama H, Hirayama Y, et al. Arterial stiffening as apossible risk factor for both atherosclerosis and diastolic heart failure.Hypertens Res. 2004;27(9):625-631.
17. Kawaguchi M, Hay I, Fetics B, Kass DA. Combined ventricular systolicand arterial stiffening in patients with heart failure and preservedejection fraction: implications for systolic and diastolic reservelimitations. Circulation. 2003;107(5):714-720.
18. Pirro M, Schillaci G, Savarese G, et al. Low-grade systemicinflammation impairs arterial stiffness in newly diagnosed hyper-cholesterolaemia. Eur J Clin Invest. 2004;34(5):335-341.
19. Kass DA. Ventricular arterial stiffening: integrating thepathophysiology. Hypertension. 2005;46(1):185-193.
20. Puddu P, Puddu GM, Zaca F, Muscari A. Endothelial dysfunction inhypertension. Acta Cardiol 2000;55(4):221-232.
21. Lemarie CA, Esposito B, Tedgui A, Lehoux S. Pressure inducedvascular activation of nuclear factor-kappa B: role in cell survival. CircRes 2003;93(3):207-212.
22. Renaudin C, Bataillard A, Sassard J. Partial transfer of genetichypertension by lymphoid cells in Lyon rats. J Hypertens. 1995;13(12 Pt2):1589-1592.
23. Chung NA, Beevers DG, Lip G. Effects of losartan versushydrochlorothiazide on indices of endothelial damage/dysfunction,angiogenesis and tissue factor in essential hypertension. Blood Pres2004;13(3):183-189.
24. D&ouml;rffel Y, L&auml;tsch C, Stuhlm&uuml;ller B, et al. Preactivated peripheral bloodmonocytes in patients with essential hypertension. Hypertension1999;34(1):113-117
25. Mc Eniery CM, Wilkinson IB. Large artery stiffness and inflammation.J Hum Hypertens 2005;19(7)507-509.
26. Mc Carron RM, Wang L, Siren AL, Spatz M, Hallenbeck JM. Monocyteadhesion to cerebromicrovascular endothelial cells derived fromhypertensive and normotensive rats. Am J Physiol. 1994;267(6 Pt2):2491-2497.
27. Vasan RS, Sullivan LM, Roubenoff R, et al. Inflammatorymarkers and risk of heart failure in elderly subjects without priormyocardial infarction: the Framingham Heart Study.Circulation.2003;107(11):1486-1491. doi:10.1161/01.cir.0000057810.48709.f6
28. Masiha S, Sundstr&ouml;m J, Lind L. Inflammatory markers are associatedwith left ventricular hypertrophy and diastolic dysfunction in apopulation-based sample of elderly men and women.J Hum Hypertens.2013;27(1):13-17. doi:10.1038/jhh.2011.113
29. Horne BD, Anderson JL, John JM et al. Intermountain HeartCollaborative Study Group. Which white blood cell subtypes predictincreased cardiovascular risk? J Am Coll Cardiol 2005;45(10):1638-1643.
30. Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, GurmHS. Association between admis&not;sion neutrophil to lymphocyte ratioand outcomes in patients with acute coronary syndrome. Am J Cardiol2008;102(6):653- 657.
31. Fauzia Imtiaz. Neutrophil lymphocyte ratio as a measure of systemicinflammation in prevalent chronic diseases in Asian population. IntArch Med. 2012;5(1):2.
32. Demir M. The Relationship Between Neutrophil Lymphocyte Ratio andNon-dipper Hypertension. Clin Exp Hypertens. 2013;35(8):570-573.
33. Liu X, Zhang Q, Wu H et al. Blood neutrophil to lymphocyte ratio as apredictor of hypertension. Am J Hypertens. 2015;28(11):1339-1346.
34. Aydin C, Alpsoy Ş, Aky&uuml;z A et al. Could the systemic immune-inflammation index be a predictor to estimate cerebrovascular eventsin hypertensive patients? Blood Press Monit. 2022;27(1):33-38.
35. Madhur MS, Elijovich F, Alexander MR, et al. Hypertension: doinflammation and immunity hold the key to solving this epidemic? CircRes. 2021;128(7):908-933. doi:10.1161/CIRCRESAHA.121.318052
36. Boos CJ, Toon LT, Almahdi H. The relationship between ambulatoryarterial stiffness, inflammation, blood pressure dipping andcardiovascular outcomes. BMC Cardiovasc Disord. 2021;21(1):139.doi:10.1186/s12872-021-01946-2
Article available in :
Volume 1, Issue 3, 2023
Page : 36-39
https://doi.org/10.51271/JCCVS-0011
Article Information
Received : 15 Ağu 2023
Accepted : 16 Eyl 2023
Published : 30 Eyl 2023
Corresponding Author :

Yasemin Doğan: Department of Cardiology, Kayseri City Hospital, Kayseri, Turkey

[email protected]
Citation : Doğan Y, Şarlı B. The relationship between neutrophil to lymphocyte ratio and diastolic dysfunction in patients with essential hypertension. J Cardiol Cardiovasc Surg. 2023;1(3):36-39.

Read: 704
Download : 799
Cited: 2
_Footer