Nizamettin Selçuk YELGEÇ, Mehmet Baran KARATAŞ, Yiğit ÇANGA, Özge GÜZELBURÇ, Dilaver ÖZ, Mehmet ZENGIN, Ayşe EMRE

The Neutrophil-To-Lymphocyte Ratio is Associated With Acute Chest Pain in Patients With Mitral Valve Prolapse

ABSTRACT INTRODUCTION: Nearly half of the patients with mitral valve prolapse (MVP) complain of chest pain. The precise cause of chest pain MVP is unknown. On the other side, the neutrophil /lymphocyte ratio (NLR) has been reported to be a useful marker of prognosis and outcomes for many cardiovascular diseases. In this study, we aimed to investigate the relationship between NLR and chest pain in patients with MVP. METHODS: In this retrospective study, we screened medical records of all consecutive patients with MVP applied to outpatient clinics between the years 2016 and 2019 at our institution. Basal characteristics, biochemical parameters, and NLR were compared between the patients with MVP and chest pain and the patients with MVP and without chest pain (control group). Independent predictors of chest pain in MVP patients were determined by logistic regression analysis. RESULTS: The patients with MVP and chest pain had significantly lower body mass index and systolic blood pressure compared to the control group. Heart rate, the number of patients with panic disorder, the number of females, NLR, and white blood cell count (WBC) were significantly higher in patients with MVP and chest pain. In the regression analysis, lower body mass index (OR= 0.76, P

Nötrofil-Lenfosit Oranı Mitral Kapak Çökmesi Olan Hastalarda Akut Göğüs Ağrısı İle İlişkilidir

ÖZ GİRİŞ ve AMAÇ: : Mitral kapak çökmesi (MVP) tanılı hastaların yarısında akut göğüs ağrısı mevcuttur. MVP tanılı hastalardaki bu ağrının tam sebebi bilinmemektedir. Diğer taraftan Nötrofil/Lenfosit oranı (NLO), birçok kardiyovasküler hastalıkta prognoz ve sonuçlar ile ilişkili olduğu bulunmuştur. Bu çalışmada, NLR ile MVP tanılı hastalardaki göğüs ağrısı arasındaki ilişki araştırılmıştır. YÖNTEM ve GEREÇLER: Bu retrospektif çalışmada 2016 ve 2019 yılları arasında enstitümüz kardiyoloji polikliniklerine başvuran MVP tanılı hastaların tıbbi kayıtları incelenmiştir. Göğüs ağrısı ile başvuran MVP tanılı hastaların bazal karakteristikleri, biyokimyasal parametreleri ve NLR değerleri, göğüs ağrısı olmayan MVP tanılı hastalar ( kontrol grup) ile mukayese edilmiştir. MVP tanılı hastalardaki göğüs ağrısının bağımsız belirteçleri lojistik regresyon yöntemi ile araştırılmıştır BULGULAR: Göğüs ağrısı olan MVP tanılı hastalarının vücut kitle endeksleri, Sistolik kan basınçları göğüs ağrısı olmayan MVP hastalarına göre anlamlı olarak daha düşük; kalp hızı, panik atak oranı, kadın cinsiyet, NLO, beyaz küre anlamlı olarak daha yüksek olarak saptandı. Regresyon analizinde, düşük vücut kitle endeksi (OR = 0.76, P

PDF

___

1.Freed LA, Benjamin EJ, Levy D, Larson MG, Evans JC, Fuller DL, et al. Mitral valve prolapse in the general population: The benign nature of echocardiographic features in the Framingham Heart Study. J Am Coll Cardiol. 2002;

2.Luxereau P, Dorent R, De Gevigney G, Bruneaval P, Chomette G, Delahaye G. Aetiology of surgically treated mitral regurgitation. Eur Heart J. 2012;

3.Papa A, Emdin M, Passino C, Michelassi C, Battaglia D, Cocci F. Predictive value of elevated neutrophil-lymphocyte ratio on cardiac mortality in patients with stable coronary artery disease. Clin Chim Acta. 2008 Sep;395(1–2):27–31.

4.Park B-J, Shim J-Y, Lee H-R, Lee J-H, Jung DH, Kim H-B, et al. Relationship of neutrophillymphocyte ratio with arterial stiffness and coronary calcium score. Clin Chim Acta. 2011 May 12;412(11–12):925–9.

5.Zazula AD, Précoma-Neto D, Gomes AM, Kruklis H, Barbieri GF, Forte RY, et al. An assessment of neutrophils/lymphocytes ratio in patients suspected of acute coronary syndrome. Arq Bras Cardiol. 2008 Jan;90(1):31–6.

6.Duffy BK, Gurm HS, Rajagopal V, Gupta R, Ellis SG, Bhatt DL. Usefulness of an Elevated Neutrophil to Lymphocyte Ratio in Predicting LongTerm Mortality After Percutaneous Coronary Intervention. Am J Cardiol. 2006 Apr 1;97(7):993– 6.

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 J Cardiol. 2010 Jan 15;105(2):186–91.

8.Rudiger A, Burckhardt OA, Harpes P, Müller SA, Follath F. The relative lymphocyte count on hospital admission is a risk factor for long-term mortality in patients with acute heart failure. Am J Emerg Med. 2006 Jul;24(4):451–4.

9.Gibson PH, Croal BL, Cuthbertson BH, Small GR, Ifezulike AI, Gibson G, et al. Preoperative neutrophil-lymphocyte ratio and outcome from coronary artery bypass grafting. Am Heart J. 2007 Nov;154(5):995–1002.

10.Bhat T, Teli S, Rijal J, Bhat H, Raza M, Khoueiry G, et al. Neutrophil to lymphocyte ratio and cardiovascular diseases: a review. Expert Rev Cardiovasc Ther. 2013 Jan 10;11(1):55–9.

11.Quiñones MA, Otto CM, Stoddard M, Waggoner A, Zoghbi WA. Recommendations for quantification of Doppler echocardiography: a report from the Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography. J Am Soc Echocardiogr. 2002;

12.Freed LA, Levy D, Levine RA, Larson MG, Evans JC, Fuller DL, et al. Prevalence and Clinical Outcome of Mitral-Valve Prolapse. N Engl J Med. 2002;

13.Devereux RB, Lutas EM, Ted Brown W, Kramer-Fox R, Laragh JH. ASSOCIATION OF MITRAL-VALVE PROLAPSE WITH LOW BODY-WEIGHT AND LOW BLOOD PRESSURE. Lancet. 1982;

14.Fontana ME, Sparks EA, Boudoulas H, Wooley CF. Mitral valve prolapse and the mitral valve prolapse syndrome. Curr Probl Cardiol. 1991 May;16(5):309–75.

15.Alpert MA, Mukerji V, Sabeti M, Russell JL, Beitman BD. Mitral valve prolapse, panic disorder, and chest pain. Medical Clinics of North America. 1991.

16.Devereux RB, Kramer-Fox R, Kligfield P. Mitral Valve Prolapse: Causes, Clinical Manifestations, and Management. Ann Intern Med. 1989 Aug 15;111(4):305.

17.de Leon AC. Mitral valve prolapse. Postgrad Med. 1980 Jan 7;67(1):66–77.

18.Boudoulas H, Kolibash AJ, Baker P, King BD, Wooley CF. Mitral valve prolapse and the mitral valve prolapse syndrome: A diagnostic classification and pathogenesis of symptoms. Am Heart J. 1989 Oct;118(4):796–818.

19.Benschop RJ, Rodriguez-Feuerhahn M, Schedlowski M. Catecholamine-Induced Leukocytosis: Early Observations, Current Research, and Future Directions. Brain Behav Immun. 1996 Jun;10(2):77–91.

20.Allen LA, Felker GM, Mehra MR, Chiong JR, Dunlap SH, Ghali JK, et al. Validation and potential mechanisms of red cell distribution width as a prognostic marker in heart failure. J Card Fail. 2010;16(3):230–8.