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Aort Kapak Sklerozunun Öngörülmesinde Yeni Hematolojik İnflamatuar Parametrelerin Önemi

Yıl 2022, Cilt: 7 Sayı: 2, 37 - 41, 01.08.2022
https://doi.org/10.25000/acem.1107825

Öz

Giriş: İnflamatuvar süreç, aort kapak sklerozunun (AKS) ilerlemesinde kritik rol oynar. Bu çalışma, AKS hastalarında hematolojik ve biyokimyasal inflamatuar belirteçleri değerlendirmeyi amaçlamaktadır.
Yöntemler: Bu çalışma retrospektif, tek merkezli olup, Haziran 2021 ile Eylül 2021 arasında ekokardiyogram yapılan ardışık 557 hasta dahil edildi. Çalışma popülasyonu AKS varlığına göre iki gruba ayrıldı. Gruplar C-reaktif protein, Nötrofil-lenfosit oranı (NLR), trombosit-lenfosit oranı (PLR) ve monosit-HDL kolesterol oranı (MHR), değerleri açısından karşılaştırıldı.
Bulgular: Çalışmaya alınan hastaların ortalama yaşı 63 ± 10 yıl olarak bulundu. AKS izlenen hastalarda C-reaktif protein (CRP), NLR, PLR ve MHR anlamlı olarak daha yüksekti. NLR için en iyi kesme değerleri 1.4 (duyarlılık %84, özgüllük %74), PLR için 116 (duyarlılık %75, özgüllük %54) ve MHR için 9,5 (duyarlılık %78, özgüllük %75) olarak tespit edildi. CRP (OR: 1.246, %95 CI: 1.117 – 1.389; p < 0,001), NLR (OR: 2.10, %95 GA: 1.456 – 3,032; p < 0.001) ve MHR (OR: 1,227, %95 CI: 1,125 – 1,339; p < 0.001) AKS nun bağımsız öngördücüleri olarak bulundu. İlaveten veriler kategorik değişken olarak analiz edildiğinde, NLR > 1,4 değeri (OR: 4,825, %95 GA: 2,430 – 9,583; p < 0.001) ve MHR > 9,5 değeri (OR: 13,937, %95 GA: 7,464 – 26,023; p < 0,001) AKS için bağımsız öngördürücü olarak bulundu.
Sonuç: Artan CRP seviyeleri, NLR ve MHR, AKS için bağımsız öngördücüler olarak tespit edildi. Hematolojik inflamatuar biyobelirteçler, AKS varlığının öngörülmesi için uygun maliyetli ve faydalı parametreler olarak önemlidir.

Kaynakça

  • 1. Otto CM, Lind BK, Kitzman DW, et al. Association of aortic-valve sclerosis with cardiovascular mortality and morbidity in the elderly. N Engl J Med. 1999; 341: 142-7.
  • 2. Akyüz AR, Özderya A, Şahin S, et al. Relation of p - wave dispersion with presystolic a - wave and aortic valve sclerosis in asymptomatic subjects. Echocardiography. 2021; 38: 386-93.
  • 3. Rossi A, Gaibazzi N, Dandale R, et al. Aortic valve sclerosis as a marker of coronary artery atherosclerosis; a multicenter study of a large population with a low prevalence of coronary artery disease. Int J Cardiol. 2014; 172: 364-7.
  • 4. Otto CM, Kuusisto J, Reichenbach DD, et al. Characterization of the early lesion of 'degenerative' valvular aortic stenosis. Histological and immunohistochemical studies. Circulation. 1994; 90: 844-53.
  • 5. Sucu M, Davutoglu V, Sari I, et al. Relationship between platelet indices and aortic valve sclerosis. Clin Appl Thromb Hemost. 2010; 16: 563-7.
  • 6. Wang TJ, Nam BH, Wilson PW, et al. Association of C-reactive protein with carotid atherosclerosis in men and women: the Framingham Heart Study. Arterioscler Thromb Vasc Biol. 2002; 22: 1662-7.
  • 7. Singh S and Torzewski M. Fibroblasts and Their Pathological Functions in the Fibrosis of Aortic Valve Sclerosis and Atherosclerosis. Biomolecules. 2019; 9.
  • 8. Balta S, Celik T, Mikhailidis DP, et al. The Relation Between Atherosclerosis and the Neutrophil-Lymphocyte Ratio. Clin Appl Thromb Hemost. 2016; 22: 405-11.
  • 9. Nagueh SF, Smiseth OA, Appleton CP, et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2016; 29: 277-314.
  • 10. Gharacholou SM, Karon BL, Shub C, et al. Aortic valve sclerosis and clinical outcomes: moving toward a definition. Am J Med. 2011; 124: 103-10.
  • 11. Carabello BA. Aortic sclerosis--a window to the coronary arteries? N Engl J Med. 1999; 341: 193-5.
  • 12. Reustle A and Torzewski M. Role of p38 MAPK in Atherosclerosis and Aortic Valve Sclerosis. Int J Mol Sci. 2018; 19.
  • 13. Dweck MR, Boon NA, and Newby DE. Calcific aortic stenosis: a disease of the valve and the myocardium. J Am Coll Cardiol. 2012; 60: 1854-63.
  • 14. Stone PH. C-reactive protein to identify early risk for development of calcific aortic stenosis: right marker? Wrong time? J Am Coll Cardiol. 2007; 50: 1999-2001.
  • 15. Sanchez PL and Mazzone A. C-reactive protein in degenerative aortic valve stenosis. Cardiovasc Ultrasound. 2006; 4: 24.
  • 16. Chen T and Yang M. Platelet-to-lymphocyte ratio is associated with cardiovascular disease in continuous ambulatory peritoneal dialysis patients. Int Immunopharmacol. 2020; 78: 106063.
  • 17. Ganjali S, Gotto AM, Jr., Ruscica M, et al. Monocyte-to-HDL-cholesterol ratio as a prognostic marker in cardiovascular diseases. J Cell Physiol. 2018; 233: 9237-46.
  • 18. Libby P. Inflammation in Atherosclerosis-No Longer a Theory. Clin Chem. 2021; 67: 131-42.
  • 19. Budzianowski J, Pieszko K, Burchardt P, et al. The Role of Hematological Indices in Patients with Acute Coronary Syndrome. Dis Markers. 2017; 2017: 3041565.
  • 20. Duffy BK, Gurm HS, Rajagopal V, et al. Usefulness of an elevated neutrophil to lymphocyte ratio in predicting long-term mortality after percutaneous coronary intervention. Am J Cardiol. 2006; 97: 993-6.
  • 21. Baysal E, Burak C, Cay S, et al. The neutrophil to lymphocyte ratio is associated with severity of rheumatic mitral valve stenosis. J Blood Med. 2015; 6: 151-6.
  • 22. Kurtul A and Ornek E. Platelet to Lymphocyte Ratio in Cardiovascular Diseases: A Systematic Review. Angiology. 2019; 70: 802-18.
  • 23. Langer HF and Gawaz M. Platelet-vessel wall interactions in atherosclerotic disease. Thromb Haemost. 2008; 99: 480-6.
  • 24. Akdag S, Akyol A, Asker M, et al. Platelet-to-Lymphocyte Ratio May Predict the Severity of Calcific Aortic Stenosis. Med Sci Monit. 2015; 21: 3395-400.
  • 25. Karataş MB, Çanga Y, Özcan KS, et al. Monocyte to high-density lipoprotein ratio as a new prognostic marker in patients with STEMI undergoing primary percutaneous coronary intervention. Am J Emerg Med. 2016; 34: 240-4.
  • 26. Jeevanantham V, Singh N, Izuora K, et al. Correlation of high sensitivity C-reactive protein and calcific aortic valve disease. Mayo Clin Proc. 2007; 82: 171-4.
  • 27. Agmon Y, Khandheria BK, Jamil Tajik A, et al. Inflammation, infection, and aortic valve sclerosis; Insights from the Olmsted County (Minnesota) population. Atherosclerosis. 2004; 174: 337-42.
  • 28. Prasad Y and Bhalodkar NC. Aortic sclerosis--a marker of coronary atherosclerosis. Clin Cardiol. 2004; 27: 671-3.

The Significance of Novel Hematologic Inflammatory Parameters in Predicting Aortic Valve Sclerosis

Yıl 2022, Cilt: 7 Sayı: 2, 37 - 41, 01.08.2022
https://doi.org/10.25000/acem.1107825

Öz

Aim: Inflammatory process plays a critical role in the progression of aortic valve sclerosis (AVS). This study aims to evaluate the haematological and biochemical inflammatory markers in AVS patients.
Methods: A retrospective observational study was included consecutive 557 patients who underwent an echocardiogram between June 2021 and September 2021. The study population was divided into two groups according to the presence of AVS. The groups were compared in terms of C-reactive protein (CRP), Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and monocyte-HDL cholesterol ratio (MHR).
Results: The mean age was 63 ± 10 years. C-reactive protein (CRP), NLR, PLR and MHR were significantly higher in patients with AVS. The best cut-off values of the NLR were 1.4 (a sensitivity of 84%, a specificity of 74%), PLR was 116 (a sensitivity of 75%, a specificity of 54%), and MHR was 9.5 (a sensitivity of 78%, a specificity of 75%). CRP (OR: 1.246, 95% CI: 1.117 – 1.389; p < 0.001), NLR (OR: 2.10, 95% CI: 1.456 – 3.032; p < 0.001), and MHR (OR: 1.227, 95% CI: 1.125 – 1.339; p < 0.001) were independent predictors of the AVS when NLR and MHR analysed as a continuous variable. Using a cut off level of NLR > 1.4 (OR: 4.825, 95% CI: 2.430 – 9.583; p < 0.001) and MHR > 9.5 (OR: 13.937, 95% CI: 7.464 – 26.023; p < 0.001) were independent predictors of the AVS.
Conclusion: Increased CRP levels, NLR and MHR were found to be independent predictors for AVS. Hematological inflammatory biomarkers are cost effective and helpful approach for prediction of AVS presence.

Kaynakça

  • 1. Otto CM, Lind BK, Kitzman DW, et al. Association of aortic-valve sclerosis with cardiovascular mortality and morbidity in the elderly. N Engl J Med. 1999; 341: 142-7.
  • 2. Akyüz AR, Özderya A, Şahin S, et al. Relation of p - wave dispersion with presystolic a - wave and aortic valve sclerosis in asymptomatic subjects. Echocardiography. 2021; 38: 386-93.
  • 3. Rossi A, Gaibazzi N, Dandale R, et al. Aortic valve sclerosis as a marker of coronary artery atherosclerosis; a multicenter study of a large population with a low prevalence of coronary artery disease. Int J Cardiol. 2014; 172: 364-7.
  • 4. Otto CM, Kuusisto J, Reichenbach DD, et al. Characterization of the early lesion of 'degenerative' valvular aortic stenosis. Histological and immunohistochemical studies. Circulation. 1994; 90: 844-53.
  • 5. Sucu M, Davutoglu V, Sari I, et al. Relationship between platelet indices and aortic valve sclerosis. Clin Appl Thromb Hemost. 2010; 16: 563-7.
  • 6. Wang TJ, Nam BH, Wilson PW, et al. Association of C-reactive protein with carotid atherosclerosis in men and women: the Framingham Heart Study. Arterioscler Thromb Vasc Biol. 2002; 22: 1662-7.
  • 7. Singh S and Torzewski M. Fibroblasts and Their Pathological Functions in the Fibrosis of Aortic Valve Sclerosis and Atherosclerosis. Biomolecules. 2019; 9.
  • 8. Balta S, Celik T, Mikhailidis DP, et al. The Relation Between Atherosclerosis and the Neutrophil-Lymphocyte Ratio. Clin Appl Thromb Hemost. 2016; 22: 405-11.
  • 9. Nagueh SF, Smiseth OA, Appleton CP, et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2016; 29: 277-314.
  • 10. Gharacholou SM, Karon BL, Shub C, et al. Aortic valve sclerosis and clinical outcomes: moving toward a definition. Am J Med. 2011; 124: 103-10.
  • 11. Carabello BA. Aortic sclerosis--a window to the coronary arteries? N Engl J Med. 1999; 341: 193-5.
  • 12. Reustle A and Torzewski M. Role of p38 MAPK in Atherosclerosis and Aortic Valve Sclerosis. Int J Mol Sci. 2018; 19.
  • 13. Dweck MR, Boon NA, and Newby DE. Calcific aortic stenosis: a disease of the valve and the myocardium. J Am Coll Cardiol. 2012; 60: 1854-63.
  • 14. Stone PH. C-reactive protein to identify early risk for development of calcific aortic stenosis: right marker? Wrong time? J Am Coll Cardiol. 2007; 50: 1999-2001.
  • 15. Sanchez PL and Mazzone A. C-reactive protein in degenerative aortic valve stenosis. Cardiovasc Ultrasound. 2006; 4: 24.
  • 16. Chen T and Yang M. Platelet-to-lymphocyte ratio is associated with cardiovascular disease in continuous ambulatory peritoneal dialysis patients. Int Immunopharmacol. 2020; 78: 106063.
  • 17. Ganjali S, Gotto AM, Jr., Ruscica M, et al. Monocyte-to-HDL-cholesterol ratio as a prognostic marker in cardiovascular diseases. J Cell Physiol. 2018; 233: 9237-46.
  • 18. Libby P. Inflammation in Atherosclerosis-No Longer a Theory. Clin Chem. 2021; 67: 131-42.
  • 19. Budzianowski J, Pieszko K, Burchardt P, et al. The Role of Hematological Indices in Patients with Acute Coronary Syndrome. Dis Markers. 2017; 2017: 3041565.
  • 20. Duffy BK, Gurm HS, Rajagopal V, et al. Usefulness of an elevated neutrophil to lymphocyte ratio in predicting long-term mortality after percutaneous coronary intervention. Am J Cardiol. 2006; 97: 993-6.
  • 21. Baysal E, Burak C, Cay S, et al. The neutrophil to lymphocyte ratio is associated with severity of rheumatic mitral valve stenosis. J Blood Med. 2015; 6: 151-6.
  • 22. Kurtul A and Ornek E. Platelet to Lymphocyte Ratio in Cardiovascular Diseases: A Systematic Review. Angiology. 2019; 70: 802-18.
  • 23. Langer HF and Gawaz M. Platelet-vessel wall interactions in atherosclerotic disease. Thromb Haemost. 2008; 99: 480-6.
  • 24. Akdag S, Akyol A, Asker M, et al. Platelet-to-Lymphocyte Ratio May Predict the Severity of Calcific Aortic Stenosis. Med Sci Monit. 2015; 21: 3395-400.
  • 25. Karataş MB, Çanga Y, Özcan KS, et al. Monocyte to high-density lipoprotein ratio as a new prognostic marker in patients with STEMI undergoing primary percutaneous coronary intervention. Am J Emerg Med. 2016; 34: 240-4.
  • 26. Jeevanantham V, Singh N, Izuora K, et al. Correlation of high sensitivity C-reactive protein and calcific aortic valve disease. Mayo Clin Proc. 2007; 82: 171-4.
  • 27. Agmon Y, Khandheria BK, Jamil Tajik A, et al. Inflammation, infection, and aortic valve sclerosis; Insights from the Olmsted County (Minnesota) population. Atherosclerosis. 2004; 174: 337-42.
  • 28. Prasad Y and Bhalodkar NC. Aortic sclerosis--a marker of coronary atherosclerosis. Clin Cardiol. 2004; 27: 671-3.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular İç Hastalıkları
Bölüm Orjinal Makale
Yazarlar

Özge Çakmak Karaaslan 0000-0003-0173-4017

Funda Başyığıt 0000-0002-0341-5346

Yayımlanma Tarihi 1 Ağustos 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 7 Sayı: 2

Kaynak Göster

Vancouver Çakmak Karaaslan Ö, Başyığıt F. The Significance of Novel Hematologic Inflammatory Parameters in Predicting Aortic Valve Sclerosis. Arch Clin Exp Med. 2022;7(2):37-41.