title: New inflammatory predictors for non-valvular atrial fibrillation: echocardiographic epicardial fat thickness and neutrophil to lymphocyte ratio.
abstract: The objective of this study was to investigate the relationship of echocardiographic epicardial fat thickness (EFT) and neutrophil to lymphocyte ratio (NLR) with different types of non-valvular atrial fibrillation (AF) in a clinical setting. A total of 197 consecutive patients were enrolled in the study. Seventy-one patients had paroxysmal non-valvular AF, 63 patients had persistent/permanent non-valvular AF, and 63 patients had sinus rhythm (control group). EFT was measured with echocardiography, while NLR was measured by dividing neutrophil count by lymphocyte count. EFT was significantly higher in patients with paroxysmal non-valvular AF compared with those in the sinus rhythm group (6.6 ± 0.7 vs. 5.0 ± 0.9 mm, p < 0.001). Persistent/permanent non-valvular AF patients had a significantly larger EFT compared with those with paroxysmal AF (8.3 ± 1.1 vs. 6.6 ± 0.7 mm, p < 0.001). EFT had a significant relationship with paroxysmal non-valvular AF (odds ratio 4.672, 95 % CI 2.329-9.371, p < 0.001) and persistent/permanent non-valvular AF (OR 24.276, 95% CI 9.285-63.474, p < 0.001). NLR was significantly higher in those with paroxysmal non-valvular AF compared with those in the sinus rhythm group (2.5 ± 0.6 vs. 1.8 ± 0.4, p < 0.001). Persistent/permanent non-valvular AF patients had a significantly larger NLR when compared with paroxysmal non-valvular AF patients (3.4 ± 0.6, vs. 2.5 ± 0.6, p < 0.001). NLR (>2.1) had a significant relationship with non-valvular AF (OR 11.313, 95% CI 3.025-42.306, b 2.426, p < 0.001). EFT and NLR are highly associated with types of non-valvular AF independent of traditional risk factors. EFT measured by echocardiography and NLR appears to be related to the duration and severity of AF.
authors.affiliation: Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey, halitacet@gmail.com.
authors.forename: Halit
authors.initials: H
authors.lastname: Acet
authors.forename: Faruk
authors.initials: F
authors.lastname: Ertaş
authors.forename: Mehmet Ata
authors.initials: MA
authors.lastname: Akıl
authors.forename: Mustafa
authors.initials: M
authors.lastname: Oylumlu
authors.forename: Nihat
authors.initials: N
authors.lastname: Polat
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Yıldız
authors.forename: Mehmet Zihni
authors.initials: MZ
authors.lastname: Bilik
authors.forename: Murat
authors.initials: M
authors.lastname: Yüksel
authors.forename: Zeynettin
authors.initials: Z
authors.lastname: Kaya
authors.forename: Mehmet Sıddık
authors.initials: MS
authors.lastname: Ulgen
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000276:immunology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006801:Humans; D016015:Logistic Models; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009504:Neutrophils / Q000276:immunology*; D016017:Odds Ratio; D010496:Pericardium / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014463:Ultrasonography