Clinical Significance Of Peripheral Blood CD4/CD8 T Cell Ratio In Patients With Ischemic Heart Failure

Objective:To analyze the clinical significance of peripheral blood CD4/CD8 T cell ratio in patients with ischemic heart failure(IHF),and provide a reference tool for clinical prevention as well as treatment of IHF.Method:In this prospective study,a total of 100 IHF patients admitted in the department of cardiology were included as the case group.According to the New York heart association(NYHA)functional class,these patients were further divided into NYHA ?(17),?(31),and IV(52)sub-groups.For comparison 50 normal patients were included as a control group.Comparisons between these groups were done to observe the changes in peripheral blood CD4+T cell,CD8+T cell,and the CD4/CD8 ratio.The potential risk factors of IHF were determined by univariate logistic regression analysis and finally,the ability of CD4/CD8 ratio as an independent predictor of IHF was explored by multivariate logistic regression analysis.Results:There was a significant decrease in peripheral blood level of CD3+T cell(816.0(607.0-1161.0)vs 1395.0(1112.0-1820.0);P<0.001),CD4+ T cell(468.0(297.0-657.0)vs 702.0(600.0-912.0);P<0.001),and CD8+T cell(312.0(193.8-460.8)vs 624.0(479.0-842.0);P<0.001)in IHF group compared with the control group.The CD4/CD8 ratio was significantly higher in IHF compared to Control(1.67±0.73 vs 1.15±0.30;P<0.001).In comparison to the control group N-terminal-pro brain natriuretic peptide(NT-proBNP)(2371.0(1122.3-4665.3)vs 50.0(50.0-75.8);P<0.001)and high sensitivity C-reactive protein(hs-CRP)(5.32(2.35-13.67)vs 1.10(0.54-2.71);P<0.001)greatly increased in IHF.Echocardiography parameters including left atrial diameter(LAD)(40.0(34.0-42.0)vs 35.0(31.0-37.0);P<0.001),left ventricular end-diastolic dimension(LVDd)(52.0(45.3-57.0)vs 47.0(45.0-49.0);P<0.001)and left ventricular end-systolic dimension(LVSd)(36.5(28.0-44.0)vs 28.0(26.8-29.0);P<0.001)were significantly increased in IHF subjects in comparison to the control subjects.Meanwhile,cardiac index(Cl)(2.7(2.2-3.1)vs 3.2(2.8-3.5);P<0.001)and left ventricular ejection fraction(LVEF)(48.5(40.0-60.0)vs 61.0(60.0-63.0);P<0.001)levels were significantly lowered in the IHF group.Additionally,the IHF patients were further divided into NYHA functional class ?,? and? groups and comparison of clinical characteristics were done between them.We found a significant increase in NT-proBNP level in NYHA ?(2707.0(1296.0-5514.0)vs 998.0(507.0-1597.0);P<0.05)and NYHA ?(3100.0(1235.0-4723.8)vs 998.0(507.0-1597.0);P<0.001)compared to NYHA ? group.Peripheral blood CD4" of NYHA ?(416.0(252.0-628.0)vs 592.0(392.0-900.0);P<0.05)was significantly lowered in comparison to NYHA ? group.Between the NYHA class groups,we did not find any statistically significant difference in age,hs-CRP,LAD,LVDd,LVSd,Cl and LVEF.Peripheral values of CD3+,CD8+ and CD4/CD8 ratio also did not have any significant difference among the NYHA functional grouping.Furthermore,multivariable regression analysis showed that age(Odds Ratio[OR]13.986;95%Confidence Interval[Cl]2.801-69.846;P<0.01),diabetes(OR 19.606;Cl 3.142-122.337;P<0.01),LVEF(OR 0.051;Cl 0.011-0.228;P<0.001),CD3(OR 0.079;95%CI 0.018-0.346;P<0.01),and CD4/CD8 ratio(OR 49.920;Cl 4.425-497.510;P<0.01),were independently linked with IHF.Conclusion:1.There is a significant decline in the peripheral CD4 T cell and CD8 T cell level in the patient with IHF,while the ratio of CD4/CD8 increased,indicating the presence of immune system regulation defect in the pathogenesis of IHF.2.The CD4/CD8 ratio(?1.68)is an independent predictor of IHF,and it could be used as clinical biomarker for the diagnosis of IHF.3.The CD4/CD8 ratio is not related with the severity of IHF.