Kurtulus KARAUZUM, Irem KARAUZUM, Umut CELIKYURT, Ahmet VURAL, Aysen AGACDIKEN

Düşük sistemik immun-inflamasyon indeksi kardiyak resenkronizasyon tedavisine yanıt ile ilişkilidir

Amaç: Trombosit, nötrofil ve lenfosit sayılarının kominasyonundan oluşan yeni bir inflamasyon belirteci olan sistemik immun-inflamsyon indeksinin (Sİİ) çeşitli malignitelerde kötü klinik sonlanımlarla ilişkili olduğu gösterilmiştir. Bununla birlikte, Sİİ ve kardiyak resenkronizasyon tedavisine (KRT) cevap arasındaki ilişki henüz çalışılmamıştır. Bu çalışmanın amacı, kalp yetersizliği (KY) hastalarında KRT tedavisine cevap ve Sİİ arasındaki ilişkiyi araştırmaktı. Gereç ve Yöntemler: KRT cihaz implantasyonu yapılan toplam 88 hasta (%54,5 erkek; ortalama yaş 58,9±12,9 yıl) çalışmaya dahil edilmiştir. Hastaların temel klinik, demografik, laboratuar ve ekokardiyografik özellikleri kaydedildi. Ekokardiyografik KRT cevabı; implantasyondan 6 ay sonrasında sol ventrikül sistol sonu volümunde %15 ve üzerinde azalma ve/veya sol ventrikül ejeksiyon fraksiyonunda (SVEF) %5 ve üzerinde artış olması olarak tanımlanmıştır.Bulgular: Çalışmaya alınan hastalardan 51 tanesi (%57,9) KRT’ye ‘’cevap vermiş’’ olarak tanımlandı. Lenfosit sayısı, SVEF ve QRS genişliği KRT ye cevap veren hastalarda vermeyenlere göre anlamlı olarak daha fazlaydı. Ayrıca, bazal kreatinin ve Sİİ düzeyleri cevap veren hastalarda vermeyenlere göre anlamlı olarak daha düşüktü. Çok değişkenli lojistik regresyon analizinde; çalışma populasyonunda Sİİ’nin 973,3 ve altında olması, SVEF ve QRS genişliği KRT’ye cevabın bağımsız öngördürücüleri olarak saptandı. Sonuç: KY hastalarında KRT tedavisine cevabın tahmininde Sİİ yeni, basit ve güvenilir bir inflamasyon belirteci olarak kullanılabilir.

Anahtar Kelimeler:

nötrofil, inflamasyon, kardiyak resenkronizasyon tedavisi

A lower systemic immune-inflammation index level is associated with response to cardiac resynchronization theraphy

Aim: The systemic immune-inflammation index (SII), a novel inflammation-based biomarker combining platelet, neutrophil and lymphocyte counts, has been shown to be associated with worse clinical outcomes in several malignancies. However, the relationship between SII and response to cardiac resynchronization theraphy (CRT) has not been evaluated yet. The aim of this study was to investigate the association between SII and response to CRT in patients with heart failure (HF). Material and Methods: A total of 88 patients (54.5% male; mean age 58.9±12.9 years) who underwent CRT device implantation were included in the study. Baseline clinical, demographic, laboratory and echocardiographic data of patients’ were recorded. An echocardiographic CRT response was defined as a decrease in left ventricular end‐systolic volume of ≥15% and/or absolute increase of 5% in left ventricular ejection fraction (LVEF) at 6‐month follow-up after CRT implantation.Results: Among included patients, a total of 51 (57.9%) patients were defined as ‘’responders’’ after 6 months of CRT implantation. Lymphocyte count, LVEF and QRS width were significantly higher in responders compared to those responders. In addition, baseline creatinine and SII levels were significantly lower in responders than nonresponders. Multivariate logistic regression analysis showed that a SII of ≤973.3, LVEF and QRS width were independent predictors for response to CRT in the study population.Conclusion: SII may be used as a novel, simple and reliable inflammatory biomarker in the prediction of response to CRT in patients with HF.

Keywords:

inflammation, neutrophil, cardiac resynchronization therapy,

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