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Predicting outcome after percutaneous balloon mitral commissurotomy

Role of neutrophil–lymphocyte ratio

Ergebnisvorhersage bei perkutaner Ballon-Mitralkommissurotomie

Bedeutung des Neutrophilen-Lymphozyten-Quotienten

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Abstract

Background

The value of the neutrophil–lymphocyte ratio (NLR) along with the severity of mitral stenosis (MS) in predicting the outcome of percutaneous balloon mitral commissurotomy (PBMC) has not been studied.

Patients and methods

Patients with severe MS undergoing PBMC between 2013 and 2014 in a university hospital were prospectively enrolled. Complete blood cell count was obtained upon admission and NLRs were calculated. The correlations between NLR with immediate PBMC success and restenosis in 1 year were evaluated.

Results

In all, 102 patients (80 women) with a mean age of 44.5 ± 13.1 years were enrolled in the study. NLR on admission was 2.6 ± 0.8 and mitral valve area (MVA) was 0.89 ± 0.18 cm2. Patients with a lower MVA at baseline had a higher NLR (p = 0.016). The rate of immediate success was 63 % for PBMC. There was no difference in NLR between patients with regard to early and late failures, as well as those who developed restenosis of the valve. Smaller valve area and the rate of valvular dilatation during PBMC were the only independent factors that predicted early and late failure, respectively.

Conclusion

NLR at the time of treatment was not useful in predicting procedural outcome or restenosis during follow-up of patients undergoing PBMC.

Zusammenfassung

Hintergrund

Bisher wurde die Bedeutung des Neutrophilen-Lymphozyten-Quotienten (NLQ) im Zusammenhang mit dem Schweregrad der Mitralstenose (MS) zur Vorhersage des Ergebnisses der perkutanen Ballon-Mitralkomissurotomie (PBMC) nicht untersucht.

Methoden

Patienten mit schwergradiger MS, bei denen zwischen 2013 und 2014 eine PBMC in einer Universitätsklinik erfolgte, wurden prospektiv in die Studie aufgenommen. Bei Aufnahme wurde ein großes Blutbild erstellt und der NLQ berechnet. Dann wurden die Korrelationen zwischen NLQ und unmittelbarem Erfolg der PBMC sowie einer Restenose nach einem Jahr ermittelt.

Ergebnisse

102 Patienten (davon 80 Frauen) mit einem Durchschnittsalter von 44,5 ± 13,1 Jahren wurden in die Studie eingeschlossen. Der NLQ bei Aufnahme lag bei 2,6 ± 0,8; und die Mitralöffnungsfläche (MVA) betrug 0,89 ± 0,18 cm2. Patienten mit niedriger MVA zu Beginn der Studie wiesen einen höheren NLQ auf (p = 0,016). Die unmittelbare Erfolgsrate betrug für die PBMC 63 %. Es gab keinen Unterschied beim NLQ zwischen den Patienten mit Früh- und Spätversagen der Therapie sowie denjenigen, bei denen eine Restenose der Klappe auftrat. Eine kleinere Klappenöffnungsfläche und die Rate der valvulären Dilatation während der PBMC waren die einzigen unabhängigen Faktoren, die sich als Prädiktoren für ein Früh- bzw. Spätversagen dieses Verfahrens eigneten.

Schlussfolgerung

Der NLQ zum Zeitpunkt der Therapie eignete sich nicht zur Vorhersage des Therapieergebnisses oder einer Restenose im Verlauf der Nachbeobachtung bei Patienten mit PBMC.

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Authors and Affiliations

  1. Cardiovascular Research Center, Tabriz University of Medical Science, Tabriz, Iran

    A. Separham MD, L. Pourafkari MD, H. Bodagh MD, S. Ghaffari MD & N. Aslanabadi MD

  2. Dept. of Anesthesiology, University at Buffalo, 77 Goodell Street, Suite #510, 14203, Buffalo, NY, USA

    L. Pourafkari MD & N. D. Nader MD, PHD

Authors
  1. A. Separham MD
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  2. L. Pourafkari MD
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  3. H. Bodagh MD
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  4. S. Ghaffari MD
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  5. N. Aslanabadi MD
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  6. N. D. Nader MD, PHD
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Correspondence to N. D. Nader MD, PHD.

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Conflict of interest

A. Separham, L. Pourafkari, H. Boudagh, S. Ghaffari, N. Aslanabadi, and N.D. Nader declare that they have no competing interest.

The research protocol was approved by the local institutional review board and was conducted in accordance with the Helsinki Declaration.

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Separham, A., Pourafkari, L., Bodagh, H. et al. Predicting outcome after percutaneous balloon mitral commissurotomy. Herz 42, 509–514 (2017). https://doi.org/10.1007/s00059-016-4488-3

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