Exploratory analysis of the neutrophil to lymphocyte ratio in patients with pulmonary arterial hypertension
Abstract Background Chronic 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 disea...
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| Format: | Article |
| Language: | English |
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BMC
2017-04-01
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| Series: | BMC Pulmonary Medicine |
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| Online Access: | http://link.springer.com/article/10.1186/s12890-017-0407-5 |
| _version_ | 1818047119695544320 |
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| author | Lars Harbaum Kaaja M. Baaske Marcel Simon Tim Oqueka Christoph Sinning Antonia Glatzel Nicole Lüneburg Karsten Sydow Carsten Bokemeyer Hans Klose |
| author_facet | Lars Harbaum Kaaja M. Baaske Marcel Simon Tim Oqueka Christoph Sinning Antonia Glatzel Nicole Lüneburg Karsten Sydow Carsten Bokemeyer Hans Klose |
| author_sort | Lars Harbaum |
| collection | DOAJ |
| description | Abstract Background Chronic 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. Methods The 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. Results An 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. Conclusions The 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. |
| first_indexed | 2024-12-10T10:00:44Z |
| format | Article |
| id | doaj.art-2e4ec20e812b4f20b3d325b4a354e35a |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-12-10T10:00:44Z |
| publishDate | 2017-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-2e4ec20e812b4f20b3d325b4a354e35a2022-12-22T01:53:21ZengBMCBMC Pulmonary Medicine1471-24662017-04-011711910.1186/s12890-017-0407-5Exploratory analysis of the neutrophil to lymphocyte ratio in patients with pulmonary arterial hypertensionLars Harbaum0Kaaja M. Baaske1Marcel Simon2Tim Oqueka3Christoph Sinning4Antonia Glatzel5Nicole Lüneburg6Karsten Sydow7Carsten Bokemeyer8Hans Klose9Center of Pulmonary Arterial Hypertension Hamburg, University Medical Center Hamburg-EppendorfCenter of Pulmonary Arterial Hypertension Hamburg, University Medical Center Hamburg-EppendorfCenter of Pulmonary Arterial Hypertension Hamburg, University Medical Center Hamburg-EppendorfCenter of Pulmonary Arterial Hypertension Hamburg, University Medical Center Hamburg-EppendorfCenter of Pulmonary Arterial Hypertension Hamburg, University Medical Center Hamburg-EppendorfCenter of Pulmonary Arterial Hypertension Hamburg, University Medical Center Hamburg-EppendorfCenter of Pulmonary Arterial Hypertension Hamburg, University Medical Center Hamburg-EppendorfCenter of Pulmonary Arterial Hypertension Hamburg, University Medical Center Hamburg-EppendorfOncology, Hematology and Stem Cell Transplantation, Department of Medicine II, University Medical Center Hamburg-EppendorfCenter of Pulmonary Arterial Hypertension Hamburg, University Medical Center Hamburg-EppendorfAbstract Background Chronic 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. Methods The 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. Results An 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. Conclusions The 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.http://link.springer.com/article/10.1186/s12890-017-0407-5Pulmonary hypertensionPulmonary arterial hypertensionInflammationWhite blood cell countNeutrophilsGranulocytes |
| spellingShingle | Lars Harbaum Kaaja M. Baaske Marcel Simon Tim Oqueka Christoph Sinning Antonia Glatzel Nicole Lüneburg Karsten Sydow Carsten Bokemeyer Hans Klose Exploratory analysis of the neutrophil to lymphocyte ratio in patients with pulmonary arterial hypertension BMC Pulmonary Medicine Pulmonary hypertension Pulmonary arterial hypertension Inflammation White blood cell count Neutrophils Granulocytes |
| title | Exploratory analysis of the neutrophil to lymphocyte ratio in patients with pulmonary arterial hypertension |
| title_full | Exploratory analysis of the neutrophil to lymphocyte ratio in patients with pulmonary arterial hypertension |
| title_fullStr | Exploratory analysis of the neutrophil to lymphocyte ratio in patients with pulmonary arterial hypertension |
| title_full_unstemmed | Exploratory analysis of the neutrophil to lymphocyte ratio in patients with pulmonary arterial hypertension |
| title_short | Exploratory analysis of the neutrophil to lymphocyte ratio in patients with pulmonary arterial hypertension |
| title_sort | exploratory analysis of the neutrophil to lymphocyte ratio in patients with pulmonary arterial hypertension |
| topic | Pulmonary hypertension Pulmonary arterial hypertension Inflammation White blood cell count Neutrophils Granulocytes |
| url | http://link.springer.com/article/10.1186/s12890-017-0407-5 |
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