Neutrophil To Lymphocyte Ratio Levels Were Increase In Primary Dilated Cardiomyopathy And Associated With Heart Association Functional Class

Objective:To explore the relationship between the ratio of neutrophil to ly-mphocyte(NLR)and the cardiac function,N-terminal pro-Brain Natriuretic Pe-ptid(NT-proBNP),left ventricular ejection fraction(LVEF)and left ventricular end diastolic diameter(LVEDD)in patients with primary dilated cardiomyopat-hy(DCM).Methods:109 patients(DCM group)with primary dilated cardiomyopathy admitted to the Department of Cardiology,the People's Hospital of Guangxi Zhu-ang Autonomous Region were enrolled in this study from September 2014 to Ja-nuary 2018.30 healthy control populations(control group)matched by age and gender were selected from the physical examination center of the People's Hosp-ital of Guangxi Zhuang Autonomous Region during the same period.The detai-led medical history data of research objects were collected,including age,gen-der,height,weight,smoking history,drinking history,and related medical hist-ory and other relevant information.Neutrophil and lymphocyte counts were ob-tained by automatic blood cell analyzer.NLR values were calculated by neutron-phil/lymphocyte counts.Biochemical indicators,such as uric acid,creatine kin-ase isoenzyme(CK-MB),lactate dehydrogenase(LDH),N-terminal pro-Brain Natriuretic Peptid(NT-Pro BNP),serum creatinine(Scr)were all detected by la-boratory medicine,the People's Hospital of Guangxi Zhuang Autonomous Regi-on according to the standard procedure.All subjects underwent colour doppler e-chocardiography(GE ViVid E7,GE Healthcare,America)to measure the relate-d indicators of LVEF and LVEDD within 24 h.Among them,the lVEF was me-asured by modified Simpson method.All data were analyzed by SPSS19.0 soft-ware,the differences of NLR between DCM group and control group were com-pared.Cardiac functional grouping was carried out for all DCM patients by usi-ng New York Heart Association Functional Class(NYHA).Serum levels of NL-R in different cardiac function grades were compared,and the correlation betw-een NLR and LVEF,LVEDD,N-terminal pro-Brain Natriuretic Peptid(NT-pro-BNP),uric acid,creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH)and other clinical indicators in DCM patients were explored.The relation-ship between NT-peoBNP and NLR level was studied by multiple linear regress-ion model.Results:The level of serum NLR in DCM group was significantly higher th-an that in control group(1.65±0.67 vs.3.13±2.59,p = 0.004),and increased gra-dually in NYHAI grade I,NYHA grade II,NYHA grade III and NYHA grade IV(NYHA grade I 1.38±0.48 vs.NYHA grade II,2.03 ±0.73 vs.NYHA grade III,3.39±2.03 vs.NYHA grade IV,6.41±4.00,p< 0.01).The correlation analysis showed that NLR was positively correlated with NT-proBNP,LVEDD,LDH,cre-atinine and uric acid in patients with primary DCM(NT-proBNPC-r=0.659,LV-ED-r=0.629,LDH-r=0.393,creatinine-r=0.295,uric acid-r=0.286,p< 0.01),and negatively correlated with LVEF(r=-0.508,p< 0.01).Multiple linear regression analysis was further used to explore the results,there was still a positive correla-tion between NLR and NT-proBNP after the correction of LVEF,LVEDD,crea-tinine and uric acid,(? =0.594,p<0.001),while there was no correlation betwee-n NT-proBNP and creatinine or LVEF(p>0.05).Conclusions:The level of NLR in patients with primary DCM is signifycantl-y higher than that in healthy control group,and the level of NLR increases with the deterioration of cardiac function.The level of NLR in primary DCM patients was positively correlated with LVEDD and NT-proBNP,and negatively correlate-ed with LVEF.After correcting the related confounding factors,NLR was still correlated with NT-proBNP,suggesting that NLR might be of some value in eval-uating the severity of cardiac failure in patients with primary DCM in clinic.