Kalp Yetmezliği Hastalarında Mükerrer Yatış ile İnflemasyon arasındaki İlişki

Yıl 2023, Cilt: 10 Sayı: 1, 1 - 7, 30.04.2023

Yasemin Kaya Ahmet Kaya Fatih Akkaya Mehmet Filiz

https://doi.org/10.56941/odutip.1273205

Cited By: 1

Öz

Amaç: Bu çalışmada kalp yetmezliği olan hastalarda inflematuar belirteçler ile bir yıl içinde tekrarlayan hastaneye yatışlar arasında ilişki olup olmadığını göstermeyi amaçladık.
Metod: 2020-2021 tarihleri arasında kardiyoloji polikliniğinde kalp yetmezliği tanısı ile takip edilen 18 yaş üstü tüm hastalar çalışmaya dahil edildi. Hastaların dosyaları taranarak sosyodemografik özellikleri, hemogram ve biyokimyasal parametreleri kaydedildi. İnflematuar belirteçlerden platelet lenfosit oranı (P/L), nötrofil lenfosit oranı (N/L), monosit HDL (monosit/HDL) oranları hesaplandı. Hastaların son bir yıl içinde kaç defa yatırılarak hastanede takip edildikleri tarandı. Hastaneye yatış sayısı ile inflematuar belirteçler arasındaki korelasyon değerlendirildi.
Bulgular: Çalışmaya 483 hasta dahil edilmiştir. Hastaların yaş ortalaması 65.65±11.75 yıl idi. Hastaların ejeksiyon fraksiyonu ortalama % 29.53±6.102 (minimum 15 maksimum 45) olarak bulundu. CRP=8.01±9.29, monosit HDL oranı=0.0172±0.010, platelet lenfosit oranı=149.24±88.80, nötrofil lenfosit oranı=4.54±4.88 olarak bulundu. Hastaların 73 (%15,1) nün bir yıl içinde hastaneye tekrarlayan yatışları olduğu tespit edildi. tekrarlayan hastaneye yatışlar ile monosit HDL oranı arasında anlamlı pozitif korelasyon bulundu (r= 0.123, p=0.007), diğer parametreler ile anlamlı bir korelasyon bulunamadı.
Sonuç: Tekrarlayan hastaneye yatışlar ile sadece monosit HDL oranı arasında anlamlı pozitif korelasyon bulundu. Diğer inflematuar belirteçler arasında anlamlı bir korelasyon bulunamadı. Tekrarlayan yatış ile inflemasyon arasındaki ilişkiyi değerlendirmek için vaka sayısının fazla olduğu daha büyük çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

kalp yetmezliği, tekrarlayan hastaneye yatış, inflematuar markırlar

The Relationship between Recurrent Hospitalization and Inflammation in Heart Failure Patients

Öz

Objective: In this study, we aimed to show whether there is a relationship between inflammatory markers and recurrent hospitalizations within 1 year in patients with heart failure.
Methods: All patients over the age of 18 who were followed up with a diagnosis of heart failure in the cardiology outpatient clinic between 2020-2021 were included in the study. The files of the patients were scanned and their sociodemographic characteristics, hemogram and biochemical parameters were recorded. Platelet lymphocyte ratio (P/L), neutrophil lymphocyte ratio (N/L), monocyte HDL (monocyte/HDL) ratios were calculated from inflammatory markers. It was screened how many times the patients were hospitalized and followed up in the hospital in the last year. The correlation between the number of hospitalizations and inflammatory markers were evaluated.
Results: 483 patients were included in the study. The mean age of the patients was 65.65±11.75 years. The mean ejection fraction of the patients was found to be 29.53±6.102% (minimum 15 and maximum 45). CRP=8.01±9.29, monocyte HDL ratio=0.0172±0.010, platelet-lymphocyte ratio=149.24±88.80, neutrophil-lymphocyte ratio=4.54±4.88.It was determined that 73 (15.1%) of the patients had recurrent hospitalizations within one year. A significant positive correlation was found between recurrent hospitalizations and monocyte HDL ratio (r= 0.123, p=0.007), but no significant correlation was found with other parameters.
Conclusion: A significant positive correlation was found between recurrent hospitalizations and only monocyte HDL ratio. No significant correlation was found between other inflammatory markers. Larger studies with a large number of cases are needed to evaluate the relationship between recurrent hospitalization and inflammation.

Anahtar Kelimeler

heart failure, recurrent hospitalization, inflammatory markers

Kaynakça

• 1. Lafuse WP, Wozniak DJ, Rajaram MVS. Role of Cardiac Macrophages on Cardiac Inflammation. Fibrosis and Tissue Repair Cells. 2020;10(1):51. doi: 10.3390/cells10010051.
• 2. Roth GA, Johnson C, Abajobir A, Abd-Allah F, Abera SF, Abyu G, et al. Global. Regional. and National Burden of Cardiovascular Diseases for 10 Causes. 1990 to 2015. J. Am. Coll. Cardiol. 2017;70:1–25. doi: 10.1016/j.jacc.2017.04.052
• 3. Frangogiannis NG. Regulation of the inflammatory response in cardiac repair. Circ Res. 2012 Jan 6;110(1):159-7
• 4. Shirazi1 LF, Bissett J, Romeo F, Mehta JL. Role of Inflammation in Heart Failure. Curr Atheroscler Rep. 2017: 19: 27
• 5. McKechnie DG, Papacosta AO, Lennon LT, Welsh P, Whincup PH. Wannamethee SG. Inflammatory markers and incident heart failure in older men: the role of NT-proBNP. Biomark Med. 2021;15(6):413-425.
• 6. Delcea C, Buzea CA, Andrei Dan GA. The neutrophil to lymphocyte ratio in heart failure: a comprehensive review. Rom J Intern Med. 2019; 57(4):296-314
• 7. Ye G, Chen Q, Chen X, Liu Y, Yin T, Meng Q, et. al. The prognostic role of platelet-to-lymphocyte ratio in patients with acute heart failure: A cohort study. Sci Rep 2019;9(1):10639.
• 8. Ganjali S, Gotto AM, Ruscica M, Atkin SL, Butler AE, Maciej Banach M, et. al. Monocyte-to-HDL-cholesterol ratio as a prognostic marker in cardiovascular diseases. J Cell Physiol 2018;233(12):9237-9246.
• 9. Halade GV, Lee DH. Inflammation and resolution signaling in cardiac repair and heart failure. Nat Rev Cardiol. 2020;17(5):269-285.
• 10. Halade GV, Norris PC, Kain V, Serhan CN, Ingle KA. Splenic leukocytes define the resolution of inflammation in heart failure. Sci Signal. 2018;11(520).
• 11. Tracy RPThe five cardinal signs of inflammation: calor dolor rubortumor and penuria (apologies to Aulus Cornelius Celsus. De medicina. c. AD 25) J Gerontol Ser A. 2006;61(10):1051–1052.
• 12. Albar Z, Albakri M, Hajjari J, Karnib M, Janus SE, Al-Kindi SG. Inflammatory Markers and Risk of Heart Failure with Reduced to Preserved Ejection Fraction. Am J Cardiol. 2022;167:68-75.
• 13. Gullestad L, Ueland T, Vinge LE, Finsen A, Yndestad A, Aukrust P. Inflammatory cytokines in heart failure: mediators and markers. Cardiology. 2012;122(1):23-35.
• 14. Ganjali S, Gotto AM JR, Ruscica M, Atkin SL, Butler AE, Banach M, et al. Monocyte-to-HDL-cholesterol ratio as a prognostic marker in cardiovascular diseases J Cell Physiol. 2018;233(12):9237-9246.
• 15. Eyyupkoca F, Yildirim O, Sivri S, Ali-Felekoglu M, Demirtas B, Sait-Altintas M, et al. Admission Monocyte/HDL Ratio Predicts Adverse Cardiac Remodeling After St-Elevation Myocardial Infarction. Rev Invest Clin. 2022;74(2):104-112