title: Lymphocytopenia is associated with poor NYHA functional class in chronic heart failure patients with reduced ejection fraction.
abstract: OBJECTIVE
  In heart failure (HF) patients, functional capacity has been demonstrated to be a marker of poor prognosis, independent of left ventricular ejection fraction (EF). Lymphocyte count is currently recognized in certain risk stratification scores for chronic HF, and severe HF is associated with lymphocytopenia. However, no data exists on the association between lymphocyte count and functional capacity in patients with stable HF. This study aimed to assess the relationship between lymphocyte count and New York Heart Association (NYHA) functional capacity in systolic HF outpatients.
  
  
  METHODS
  The Turkish Research Team-HF (TREAT-HF) is a network which undertakes multi-center observational studies in HF. Data on 392 HF reduced ejection fraction (HFREF) patients from 8 HF centers are presented here. The patients were divided into two groups and compared: Group 1 comprised stable HFREF patients with mild symptoms (NYHA Class I-II), while Group 2 consisted of patients with NYHA Class III-IV symptoms.
  
  
  RESULTS
  Patient mean age was 60±14 years. Lymphocyte count was lower in patients with NYHA functional classes III and IV than in patients with NYHA functional classes I and II, (0.9 [0.6-1.5]x1000 versus 1.5 [0.7-2.2]x1000, p<0.001). In multivariate logistic regression analysis, lymphocyte count (OR: 0.602, 95% CI: 0.375-0.967, p=0.036), advanced age, male gender, presence of hypertension, EF, left atrium size, systolic pulmonary artery pressure, neutrophil and basophil counts, creatinine level, and diuretic usage were associated with poor NYHA functional class in systolic HF outpatients.
  
  
  CONCLUSIONS
  The present study demonstrated that in stable HFREF outpatients, lymphocytopenia was strongly associated with poor NYHA function, independent of coronary heart disease risk factors.
authors.affiliation: Department of Cardiology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Yücel
authors.affiliation: Department of Cardiology, Private Sincan Koru Hospital, Ankara, Turkey.
authors.forename: Meltem
authors.initials: M
authors.lastname: Refiker Ege
authors.affiliation: Department of Cardiology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Zorlu
authors.affiliation: Department of Cardiology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey.
authors.forename: Hakki
authors.initials: H
authors.lastname: Kaya
authors.affiliation: Department of Cardiology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Beton
authors.affiliation: Department of Cardiology, Adnan Menderes University Faculty of Medicine, Aydın, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Güngör
authors.affiliation: Department of Cardiology, Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey.
authors.forename: Gürkan
authors.initials: G
authors.lastname: Acar
authors.affiliation: Department of Cardiology, Yüksek Ihtisas Hospital, Ankara, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Temizhan
authors.affiliation: Department of Cardiology, Osmangazi University Faculty of Medicine, Eskişehir, Turkey.
authors.forename: Yüksel
authors.initials: Y
authors.lastname: Çavuşoğlu
authors.affiliation: Department of Cardiology, Ege University Faculty of Medicine, İzmir, Turkey.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Zoghi
authors.affiliation: Department of Cardiology, Siyami Ersek Training and Research Hospital, İstanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Eren
authors.affiliation: Department of Cardiology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Ural
authors.affiliation: Department of Cardiology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey.
authors.forename: Mehmet Birhan
authors.initials: MB
authors.lastname: Yılmaz
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000150:complications* / Q000453:epidemiology* / Q000503:physiopathology*; D006801:Humans; D008231:Lymphopenia / Q000150:complications* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013318:Stroke Volume; D014421:Turkey