Exploratory analysis of the neutrophil to lymphocyte ratio in patients with pulmonary arterial hypertension

BMC Pulmonary Medicine

Research Article

Christoph Sinning¹  Karsten Sydow¹  Nicole Lüneburg²  Antonia Glatzel²  Kaaja M. Baaske³  Marcel Simon³  Tim Oqueka³  Hans Klose³  Lars Harbaum³  Carsten Bokemeyer⁴ 

[1] Center of Pulmonary Arterial Hypertension Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany;Center of Pulmonary Arterial Hypertension Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;Center of Pulmonary Arterial Hypertension Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;Section Pneumology, Department of Medicine II, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;Oncology, Hematology and Stem Cell Transplantation, Department of Medicine II, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;

关键词: Pulmonary hypertension;    Pulmonary arterial hypertension;    Inflammation;    White blood cell count;    Neutrophils;    Granulocytes;    Eosinophils;    C-reactive protein;    Survival;    Prognosis;   

DOI  :  10.1186/s12890-017-0407-5

 received in 2016-02-18, accepted in 2017-04-05,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundChronic inflammation emerges as a feature of the pathogenesis of pulmonary arterial hypertension (PAH) in experimental models. Alterations of circulating cell subsets have been observed in patients with PAH. We aimed to assess associations of the white blood cell count with disease severity and outcome in patients with PAH.MethodsThe total and differential white blood cell count was related to functional parameters, pulmonary hemodynamics and transplantation-free survival in 77 patients with PAH in an observational single center study.ResultsAn increased neutrophil/lymphocyte ratio was associated with poor World Health Organization functional class and shorter 6-minute walking distance, as well as with elevated right atrial pressure and high level of N-terminal prohormone of brain natriuretic peptide. During a median follow-up period of 31 months (range 16-56) 23 patients died and 2 patients were referred to lung transplantation. Using uni- and subsequent bivariate Cox proportional hazards analyses an increased neutrophil/lymphocyte ratio was associated with unfavorable transplantation-free survival independent of hemodynamic parameters and C-reactive protein. The prognostic implication sustained in subsets of patients with incident PAH and in the absence of cardiovascular risk factors.ConclusionsThe results of this analysis indicate that a neutrophilic inflammation may be associated with clinical deterioration and poor outcome in patients with PAH. Assessing the composition of the differential white blood cell count may render prognostic information and could represent a step towards incorporating an inflammatory marker into the clinical management of patients with PAH.

【 授权许可】

CC BY   
© The Author(s). 2017