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Abstract

Aim It has been shown that heart rate recovery index is an independent risk factor for cardiovascular mortality. It has been reported in most epidomiologic studies that an elevated associated with cardiovascular diseases. The aim of this study was to investigate whether there is a relationship between heart rate recovery index and neutrophillymphocyte ratio. Materials and Methods A total of 238 patients who underwent coronary angiography due to abnormal treadmill exercise test results and who admitted to Cardiology Department of Faculty of Medicine at Namık Kemal University were evaluated retrospectively. heart rate recovery index was

Keywords

• Heart rate recovery index, neutrophil

Nötrofil Lenfosit Oranının Kalp Hızı Toparlanma İndeksi ile İlişkisi

Öz

GİRİŞ Kalp Hızı Toparlanma İndeksinin kardiyovasküler mortalitenin bağımsız bir risk faktörü olduğu gösterilmiştir. Yükselen nötrofil-lenfosit oranının bir çok epidemiylojik çalışmada Kardiyovasküler hastalıklar ile kuvvetli ilişki içinde olduğu bildirilmiştir. Bu çalışmanın amacı Kalp Hızı Toparlanma İndeksi ile nötrofil-lenfosit oranı arasındaki ilişkiyi araştırmaktırır. MATERYAL ve METOD Namık Kemal Üniversitesi Araştırma ve Uygulama Hastanesi Kardiyoloji Polikliniği’ne, başvuran, anormal efor testi nedeniyle koroner anjiyografi yapılan 238 hasta retrospektif olarak değerlendirilmiştir. Egzersiz sırasındaki maksimum kalp hızından istirahatin 1. dakikasındaki kalp hızı çıkartılarak 18 atım ve altı değerler anormal olarak kabul edildi. SONUÇLAR Kalp Hızı Toparlanma İndeksinin normal olanlar ile anormal olan bireyler arasıda Nötrofil sayısı ve nötrofil-lenfosit oranı karşılaştırılmasında istatistiksel olarak anlamlı bir ilişkili olduğunu tespit edilmiştir. (sırasıyla p=0,027 ve p=0.000). TARTIŞMA Sonuç olarak mevcut bulgularımız anormal Kalp Hızı Toparlanma İndeksli hastalarda artan nötrofil-lenfosit oranının kardiyovasküler mortalite ve morbidite ile ilşkili olabileceğini düşündürmektedir. Gelecekte yapılacak prospektif çalışmalar ile egzersizin anormal Kalp Hızı Toparlanma İndeksli bireylerde nötrofil-lenfosit oranının üzerine etkisinin araştırılması bu konuda daha kesin deliller sağlayacaktır.

Anahtar Kelimeler

• Kalp hızı toparlanma İndeksi, nötrofillenfosit oranı, kardiyovasküler mortalite

Kaynakça

1. 1. Imai K, Sato H, Hori M, et al. Vagally mediated heart rate recovery after exercise is accelerated in athletes but blunted in patients with chronic heart failure. J Am Coll Cardiol 1994;24(6):1529-35.
2. 2. Sears CE, Choate JK, Paterson DJ. Inhibition of nitric oxide syntase slows heart rate recovery from cholinergic activation. J Apll Physiol 1998;84(5):1596- 603.
3. 3. Higgins JP, Higgins JA. Electrocardiographic exercise stress testing: An update beyond the ST segment. Int J Cardiol 2007;116(3):285-99.
4. 4. Palatini P. Heart rate as an independent risk factor for cardiovascular disease: current evidence and basic mechanisms. Drugs. 2007; 67(2): 3-13
5. 5. Perret-Guillaume C, Joly L, Benetos A. Heart rate as a risk factor for cardiovascular disease. Prog Cardiovasc Dis. 2009;52(1):6-10.
6. 6. Morshedi-Meibodi A, Larson MG, Levy D, O'Donnell CJ, Vasan RS. Heart rate recovery after treadmill exercise testing and risk of cardiovascular disease events (The Framingham Heart Study). Am J Cardiol 2002;90(8):848-52.
7. 7. Adamsson Eryd S, Smith JG, Melander O, Hedblad B, Engström G. Incidence of coronary events and case fatality rate in relation to blood lymphocyte and neutrophil counts. Arterioscler Thromb Vasc Biol. 2012;32(2):533-9.
8. 8. Cho KH, Jeong MH, Ahmed K, et al. Value of early risk stratification using hemoglobin level and neutrophil-tolymphocyte ratio in patients with STelevation myocardial infarction undergoing primary percutaneous coronary intervention. Am J Cardiol. 2011;107(6):849-56.

9. 9. Guasti L, Dentali F, Castiglioni L, et al. Neutrophils and clinical outcomes in patients with acute coronary syndromes and/or cardiac revascularization: a systematic review on more than 34,000 subjects. Thromb Haemost. 2011;106(4):591-9.
10. 10. Uthamalingam S, Patvardhan EA, Subramanian S, et al. Utility of the neutrophil to lymphocyte ratio in predicting long-term outcomes in acute decompensated heart failure. Am J Cardiol. 2011;107(3):433-8.
11. 11. Azab B, Zaher M, Weiserbs KF, et al. Usefulness of neutrophil to lymphocyte ratio in predicting short- and long-term mortality after non-ST-elevation myocardial infarction. Am J Cardiol. 2010;106(4):470-6.
12. 12. Baetta R, Corsini A. Role of polymorphonuclear neutrophils in atherosclerosis:current state and future perspectives. Atherosclerosis. 2010;210(1):1-13.
13. 13. Horne BD, Anderson JL, John JM, et al. Which white blood cell subtypes predict increased cardiovascular risk? J Am Coll Cardiol. 2005;45(10):1638-43.
14. 14. Chacko KM, Bauer TA, Dale RA, et al. Heart rate recovery predicts mortality and cardiovascular events in patients with type 2 diabetes. Med Sci Sports Exerc. 2008;40(2):288-95.
15. 15. Hao SC, Chai A, Kligfield P. Heart rate recovery response to sypmtom-limited treadmill exercise after cardiac rehabilitation in patients with coronary artery disease with and without recent events. Am J Cardiol 2002;90(7):763-5.
16. 16. Mensink GB, Ziese T, Kok FJ. Benefits of leisure-time physical activity on the cardiovascular risk profile at older age. Int J Epidemiol. 1999;28(4):659-66.
17. 17. Bijnen FC, Feskens EJ, Caspersen CJ, et al. Physical activity and cardiovascular risk factors among elderly men in Finland, Italy, and the Netherlands. Am J Epidemiol. 1996;143(6):553-61.
18. 18. Youn HJ, Park CS, Moon KW, et al. Relation between Duke Tredmil Score and coronary flow reserve using trans-esophageal Doppler echocardiography in patients with microvascular angina. Int J Cardiol. 2005;98(3):403-8.
19. 19. Jagethesan R, Kaufmann PA, Rosen SD, et al. Assessment of the long-term reproducibility of baseline and dobutamine- induced myocardial blood flow in patients with stable coronary artery disease. J Nucl Med. 2005;46(2):212-9.
20. 20. Ören H, Aytemir K. Kalp Hızı Toparlanma İndeksi (Heart Rate Recovery): Klinik Kullanım ve Yöntemler. Turk Aritmi, Pacemaker ve Elektrofizyoloji Dergisi. 2008;6(3): 141-150.
21. 21. Lipinski JM, Vetrovec GW, Froelicher VF. Importance of the first two minutes of heart rate recovery after exercise treadmill testing in predicting mortality and the presence of coronaryvartery disease in men. Am J Cardiol 2004;93(4):445-9.
22. 22. Ghaffari S, Kazemi B, Aliakbarzadeh P. Abnormal heart rate recovery after exercise predicts coronary artery disease severity. Cardiol J 2011;18(1):47-54.
23. 23. Tigen K, Karaahmet T, Gürel E, et al. The utility of heart rate recovery to predict right ventricular systolic dysfunction in patients with obesity. Anadolu Kardiyoloji Dergisi 200;9(6):473-9.
24. 24. Williams BA, Merhige ME. Association between neutrophil-lymphocyte ratio and impaired myocardial perfusion in patients with known or suspected coronary disease Heart Lung. 2013;42(6):436-41.
25. 25. Ziyrek M, Tayyareci Y, Yurdakul S, et al. Association of mitral annular calcification with endothelial dysfunction, carotid intima-media thickness and serum fetuin-A: an observational study Anadolu Kardiyol Derg. 2013;13(8):752-8.
26. 26. Chacko KM, Bauer TA, Dale RA, et al. Heart rate recovery predicts mortality and cardiovascular events in patients with type 2 diabetes. Med Sci Sports Exerc 2008;40(2):288-95.
27. 27. Hao SC, Chai A, Kligfield P. Heart rate recovery response to sypmtom-limited treadmill exercise after cardiac rehabilitation in patients with coronary artery disease with and without recent events. Am J Cardiol 2002;90(7):763-5.
28. 28. Mensink GB, Ziese T, Kok FJ. Benefits of leisure-time physical activity on the cardiovascular risk profile at older age. Int J Epidemiol 1999;28(4):659-66.