Monosit HDL-kolesterol oranı ile mitral annülüs kalsifikasyonu arasındaki ilişki

Yıl 2019, Cilt: 3 Sayı: 1, 44 - 48, 27.01.2019

Hilal Erken Pamukcu Mert Aker

https://doi.org/10.28982/josam.512374

Öz

Amaç: Mitral annülüs kalsifikasyonu (MAK) mitral kapak annülüsünün dejeneratif kalsifikasyonu ile karakterizedir, MAK ve ateroskleroz risk faktörleri ve patogenez bakımından benzer özellikler taşır. Monosit sayısının yüksek dansiteli lipoproteine (HDL) oranı (MHO) birçok aterosklerotik hastalıkla ilişkili bir inflamatuvar belirteçtir. Biz MAK varlığı ile MHO derecesinin ilişkisini ortaya koymayı amaçladık.

Yöntemler: Bu retrospektif kohort çalışma ekokardiyografi laboratuvarımıza başvurmuş 245 [MAK(+) 200 çalışma grubu hastası, MAK(-) 45 kontrol grubu hastası] ile yapılmıştır. Grupların demografik özellikleri; yaş, hipertansiyon ve diyabetes mellitus varlığı açısından benzerdi. Tümünün laboratuvar ve ekokardiyografik parametreleri değerlendirildi.

Bulgular: Gruplar ekokardiyografik veriler olan sol atriyum çapı, pulmoner arter sistolik basıncı (PASB) açısından karşılaştırıldığında MAK varlığı ile pozitif yönde ilişkili saptandı(sırasıyla, r=0,271, p<0,001; r=0,329, p<0,001). Monosit HDL kolesterol oranı, MAK (+) grupta MAK (-) ruba göre istatistiksel olarak anlamlı derecede yüksekti {15,3 (11,9-20,6) vs. 10,8 (8,6-16,9) p<0,001}. Korelasyon analizine göre Monosit HDL oranı MAK varlığıyla anlamlı olarak ilişkili saptandı (r=0,273; p<0.001).

Sonuç: Sonuçlarımız MAK bulunan hastalarda MHO’nun anlamlı derecede yüksek olduğunu ve MAK ile MHO‘nun anlamlı derecede körele olduğunu ortaya koymuştur.

Anahtar Kelimeler

Mitral annülüs kalsifikasyonu, Monosit, HDL

Association between monocyte to HDL cholesterol ratio and mitral annulus calcification

Öz

Aim: Mitral annulus calcification (MAC) is characterized by degenerative calcification of the mitral valve annulus, MAC and atherosclerosis are similar in regard to risk factors and pathogenesis. Monocyte count to high density lipoprotein (HDL) cholesterol ratio (MHR) is an inflammatory marker that is associated with several atherosclerotic diseases. We aimed to show the association of MHR levels with the presence of MAC.

Methods: This retrospective cohort study was conducted with MAC (+) patients who admitted to our echocardiography laboratory which constituted the study group (n=200) and MAC (-) patients which constituted the control group. Demographic features like age and sex, presence of hypertension and diabetes mellitus were similar between groups. Laboratory and echocardiographic parameters were recorded and evaluated for statistical analysis.

Results: When groups were compared according to echocardiographic parameters; left atrial diameter, pulmonary artery systolic pressure (PASP) were found to be positively correlated with the presence of MAC (r=0.271, p<0.001; r=0.329, p<0.001, respectively). MHR was significantly higher in study group {15.3 (11.9-20.6) vs. 10.8 (8.6-16.9) p<0.001}. In correlation analysis, MHR value was found to be positively correlated with presence of MAC (r=0.273; p <0.001).

Conclusion: We found that the presence of MAC was associated with higher MHR, and MHR was significantly correlated with MAC.

Anahtar Kelimeler

Mitral annulus calcification, Monocyte, HDL

Kaynakça

• 1. Korn D, Desanctis RW, Sell S. Massive calcification of the mitral annulus. A clinicopathological study of fourteen cases. The New England Journal of Medicine. 1962;267:900-9. doi: 10.1056/NEJM196211012671802. PubMed PMID: 14034804.
• 2. Nestico PF, Depace NL, Morganroth J, Kotler MN, Ross J. Mitral annular calcification: clinical, pathophysiology, and echocardiographic review. American Heart Journal. 1984;107(5 Pt 1):989-96. PubMed PMID: 6372421.
• 3. Kanjanauthai S, Nasir K, Katz R, Rivera JJ, Takasu J, Blumenthal RS, et al. Relationships of mitral annular calcification to cardiovascular risk factors: the Multi-Ethnic Study of Atherosclerosis (MESA). Atherosclerosis. 2010;213(2):558-62. doi: 10.1016/j.atherosclerosis.2010.08.072. PubMed PMID: 20926076; PubMed Central PMCID: PMC2997868.
• 4. Shohat-Zabarski R, Paz R, Adler Y, Vaturi M, Jortner R, Sagie A. Mitral annulus calcification with a mobile component as a possible source of embolism. The American Journal of Geriatric Cardiology. 2001;10(4):196-8. PubMed PMID: 11455239.
• 5. Abramowitz Y, Jilaihawi H, Chakravarty T, Mack MJ, Makkar RR. Mitral Annulus Calcification. Journal of the American College of Cardiology. 2015;66(17):1934-41. doi: 10.1016/j.jacc.2015.08.872. PubMed PMID: 26493666.
• 6. Roberts WC. The senile cardiac calcification syndrome. The American Journal of Cardiology. 1986;58(6):572-4. PubMed PMID: 3751927.
• 7. Adler Y, Koren A, Fink N, Tanne D, Fusman R, Assali A, et al. Association between mitral annulus calcification and carotid atherosclerotic disease. Stroke. 1998;29(9):1833-7. PubMed PMID: 9731604.
• 8. Adler Y, Herz I, Vaturi M, Fusman R, Shohat-Zabarski R, Fink N, et al. Mitral annular calcium detected by transthoracic echocardiography is a marker for high prevalence and severity of coronary artery disease in patients undergoing coronary angiography. The American Journal of Cardiology. 1998;82(10):1183-6. PubMed PMID: 9832091.
• 9. Kurtoglu E, Korkmaz H, Akturk E, Yilmaz M, Altas Y, Uckan A. Association of mitral annulus calcification with high-sensitivity C-reactive protein, which is a marker of inflammation. Mediators of Inflammation. 2012;2012:606207. doi: 10.1155/2012/606207. PubMed PMID: 22529527; PubMed Central PMCID: PMC3316973.
• 10. Varol E, Aksoy F, Ozaydin M, Erdogan D, Dogan A. Association between neutrophil-lymphocyte ratio and mitral annular calcification. Blood Coagulation & Fibrinolysis. 2014;25(6):557-60. doi: 10.1097/MBC.0000000000000094. PubMed PMID: 24561537.
• 11. Murphy AJ, Woollard KJ, Hoang A, Mukhamedova N, Stirzaker RA, McCormick SP, et al. High-density lipoprotein reduces the human monocyte inflammatory response. Arteriosclerosis, Thrombosis, and Vascular Biology. 2008;28(11):2071-7. doi: 10.1161/ATVBAHA.108.168690. PubMed PMID: 18617650.
• 12. Acikgoz N, Kurtoglu E, Yagmur J, Kapicioglu Y, Cansel M, Ermis N. Elevated Monocyte to High-Density Lipoprotein Cholesterol Ratio and Endothelial Dysfunction in Behcet Disease. Angiology. 2018;69(1):65-70. doi: 10.1177/0003319717704748. PubMed PMID: 28421814.
• 13. Kundi H, Gok M, Kiziltunc E, Cetin M, Cicekcioglu H, Cetin ZG, et al. Relation Between Monocyte to High-Density Lipoprotein Cholesterol Ratio With Presence and Severity of Isolated Coronary Artery Ectasia. The American Journal of Cardiology. 2015;116(11):1685-9. doi: 10.1016/j.amjcard.2015.08.036. PubMed PMID: 26434515.
• 14. Cetin MS, Ozcan Cetin EH, Kalender E, Aydin S, Topaloglu S, Kisacik HL, et al. Monocyte to HDL Cholesterol Ratio Predicts Coronary Artery Disease Severity and Future Major Cardiovascular Adverse Events in Acute Coronary Syndrome. Heart, Lung & Circulation. 2016;25(11):1077-86. doi: 10.1016/j.hlc.2016.02.023. PubMed PMID: 27118231.
• 15. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. European Heart Journal Cardiovascular Imaging. 2015;16(3):233-70. doi: 10.1093/ehjci/jev014. PubMed PMID: 25712077.
• 16. Potpara TS, Vasiljevic ZM, Vujisic-Tesic BD, Marinkovic JM, Polovina MM, Stepanovic JM, et al. Mitral annular calcification predicts cardiovascular morbidity and mortality in middle-aged patients with atrial fibrillation: the Belgrade Atrial Fibrillation Study. Chest. 2011;140(4):902-10. doi: 10.1378/chest.10-2963. PubMed PMID: 21436252.
• 17. Yayla C, Akboga MK, Canpolat U, Gayretli Yayla K, Kuyumcu MS, Bayraktar F, et al. The association of the platelet-to-lymphocyte ratio with mitral annular calcification. Scandinavian Cardiovascular Journal : SCJ. 2015;49(6):351-6. doi: 10.3109/14017431.2015.1076935. PubMed PMID: 26287644.
• 18. Fox CS, Larson MG, Vasan RS, Guo CY, Parise H, Levy D, et al. Cross-sectional association of kidney function with valvular and annular calcification: the Framingham heart study. Journal of the American Society of Nephrology : JASN. 2006;17(2):521-7. doi: 10.1681/ASN.2005060627. PubMed PMID: 16382018.
• 19. Adler Y, Fink N, Spector D, Wiser I, Sagie A. Mitral annulus calcification--a window to diffuse atherosclerosis of the vascular system. Atherosclerosis. 2001;155(1):1-8. PubMed PMID: 11223420.
• 20. Barasch E, Gottdiener JS, Marino Larsen EK, Chaves PH, Newman AB. Cardiovascular morbidity and mortality in community-dwelling elderly individuals with calcification of the fibrous skeleton of the base of the heart and aortosclerosis (The Cardiovascular Health Study). The American Journal of Cardiology. 2006;97(9):1281-6. doi: 10.1016/j.amjcard.2005.11.065. PubMed PMID: 16635596.
• 21. Adler Y, Shohat-Zabarski R, Vaturi M, Shapira Y, Ehrlich S, Jortner R, et al. Association between mitral annular calcium and aortic atheroma as detected by transesophageal echocardiographic study. The American Journal of Cardiology. 1998;81(6):784-6. PubMed PMID: 9527095.
• 22. Wu MY, Li CJ, Hou MF, Chu PY. New Insights into the Role of Inflammation in the Pathogenesis of Atherosclerosis. International Journal of Molecular Sciences. 2017;18(10). doi: 10.3390/ijms18102034. PubMed PMID: 28937652; PubMed Central PMCID: PMC5666716.
• 23. Fox CS, Guo CY, Larson MG, Vasan RS, Parise H, O'Donnell CJ, et al. Relations of inflammation and novel risk factors to valvular calcification. The American Journal of Cardiology. 2006;97(10):1502-5. doi: 10.1016/j.amjcard.2005.11.086. PubMed PMID: 16679093.
• 24. Mann DL. Inflammatory mediators and the failing heart: past, present, and the foreseeable future. Circulation Research. 2002;91(11):988-98. PubMed PMID: 12456484.
• 25. Frantz S, Bauersachs J, Ertl G. Post-infarct remodelling: contribution of wound healing and inflammation. Cardiovascular Research. 2009;81(3):474-81. doi: 10.1093/cvr/cvn292. PubMed PMID: 18977766; PubMed Central PMCID: PMC2639128.
• 26. Lambert JM, Lopez EF, Lindsey ML. Macrophage roles following myocardial infarction. International Journal of Cardiology. 2008;130(2):147-58. doi: 10.1016/j.ijcard.2008.04.059. PubMed PMID: 18656272; PubMed Central PMCID: PMC2857604.
• 27. Yvan-Charvet L, Pagler T, Gautier EL, Avagyan S, Siry RL, Han S, et al. ATP-binding cassette transporters and HDL suppress hematopoietic stem cell proliferation. Science. 2010;328(5986):1689-93. doi: 10.1126/science.1189731. PubMed PMID: 20488992; PubMed Central PMCID: PMC3032591.
• 28. Murphy AJ, Woollard KJ. High-density lipoprotein: a potent inhibitor of inflammation. Clinical and Experimental Pharmacology & Physiology. 2010;37(7):710-8. doi: 10.1111/j.1440-1681.2009.05338.x. PubMed PMID: 19930423.
• 29. Murphy AJ, Chin-Dusting JP, Sviridov D, Woollard KJ. The anti inflammatory effects of high density lipoproteins. Current Medicinal Chemistry. 2009;16(6):667-75. PubMed PMID: 19199930.
• 30. Kanbay M, Solak Y, Unal HU, Kurt YG, Gok M, Cetinkaya H, et al. Monocyte count/HDL cholesterol ratio and cardiovascular events in patients with chronic kidney disease. International Urology and Nephrology. 2014;46(8):1619-25. doi: 10.1007/s11255-014-0730-1. PubMed PMID: 24853998.
• 31. Karatas MB, Canga Y, Ozcan KS, Ipek G, Gungor B, Onuk T, et al. Monocyte to high-density lipoprotein ratio as a new prognostic marker in patients with STEMI undergoing primary percutaneous coronary intervention. The American Journal of Emergency Medicine. 2016;34(2):240-4. doi: 10.1016/j.ajem.2015.10.049. PubMed PMID: 26585199.
• 32. Yilmaz S, Akboga MK, Sen F, Balci KG, Aras D, Temizhan A, et al. Usefulness of the monocyte-to-high-density lipoprotein cholesterol ratio to predict bare metal stent restenosis. Biomarkers in Medicine. 2016;10(9):959-66. doi: 10.2217/bmm-2016-0069. PubMed PMID: 27537215.
• 33. Ucar FM. A potential marker of bare metal stent restenosis: monocyte count - to- HDL cholesterol ratio. BMC Cardiovascular Disorders. 2016;16(1):186. doi: 10.1186/s12872-016-0367-3. PubMed PMID: 27716070; PubMed Central PMCID: PMC5048646.