title: Neutrophil/lymphocyte ratio is related to the severity of idiopathic dilated cardiomyopathy.
abstract: OBJECTIVE
  The aim of this study was to assess whether NLR levels are associated with echocardiographic parameters, New York Heart Association (NYHA) functional class, or B- type natriuretic peptide (BNP) levels in patients with idiopathic dilated cardiomyopathy (DCM).
  
  
  METHODS
  Eighty-seven patients with idiopathic DCM were included prospectively from 2009 to 2014. Patients with acute decompensated heart failure and conditions that alter the total or differential white blood cell counts were excluded. Blood samples were collected before echocardiographic investigation on admission.
  
  
  RESULTS
  There was a statistically significant correlation between neutrophil/lymphocyte ratio (NLR) and NYHA functional class (r = 0.68, p < 0.001), BNP levels (r = 0.61, p < 0.001) and various echocardiographic parameters. NLR was significantly higher in patients in NYHA functional class III or IV (n = 39) than among those categorized as NYHA class I or II (n = 48), (3.3 ± 1.0 vs 2.1 ± 0.6; p < 0.001). The NLR cutoff value predicting severe chronic HF was 2.25 with 82% sensitivity and 65% specificity (p < 0.001). On multivariate linear regression analysis NLR (p = 0.025), left ventricular end-diastolic volume (p = 0.041) and left atrial volume index (LAVI) (p = 0.001) were found to be independent positive predictors of BNP levels.
  
  
  CONCLUSIONS
  Neutrophil/Lymphocyte ratio is associated with the severity of chronic heart failure in patients with idiopathic DCM.
authors.affiliation: Department of Cardiology, Kartal Koşuyolu Cardiovascular Research and Training Hospital , Kartal, Istanbul , Turkey.
authors.forename: Anil
authors.initials: A
authors.lastname: Avci
authors.forename: Elnur
authors.initials: E
authors.lastname: Alizade
authors.forename: Serdar
authors.initials: S
authors.lastname: Fidan
authors.forename: Mahmut
authors.initials: M
authors.lastname: Yesin
authors.forename: Yeliz
authors.initials: Y
authors.lastname: Guler
authors.forename: Ramazan
authors.initials: R
authors.lastname: Kargin
authors.forename: Ali Metin
authors.initials: AM
authors.lastname: Esen
mesh_terms: D000328:Adult; D016279:Atrial Function, Left; D015415:Biomarkers / Q000097:blood; D002311:Cardiomyopathy, Dilated / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D016014:Linear Models; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood; D009504:Neutrophils; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index; D013318:Stroke Volume; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain
keywords: echocardiography; idiopathic dilated cardiomyopathy; inflammation; neutrophil/lymphocyte ratio