Abstract 11981: Neutrophil-To-Lymphocyte Ratio and Ventricular Arrhythmia in Mitral Valve Prolapse

Abstract

Introduction: Inflammation may mediate the association of mitral valve prolapse (MVP) with ventricular scarring and arrhythmia. The purpose of this study is to investigate the association of neutrophil- and platelet-to-lymphocyte ratios (NLR, PLR) with ventricular arrhythmia in MVP. Hypothesis: We hypothesized that hematological markers of inflammation predict ventricular arrhythmia in MVP. Methods: Clinical and demographic data were extracted from electronic medical records for all patients aged 18-90 years with MVP on echocardiography between 2016-19 at our institution. We studied 65 patients who had a differential blood count within six months prior to an ambulatory ECG (A- ECG) monitor (median age [IQR] 69.6 [60.5-77.1] years; 61.5% female; 12.3% African American). Patients with surgery or infection within six months prior to CBC were excluded. PVC burden and complex ventricular ectopy (cVE) on A-ECG were compared with NLR and PLR. Logistic and bivariate regression was used to analyze clinical, ECG, and echocardiographic factors associated with NLR and PLR. Results: Factors associated with NLR were congestive heart failure (p=0.005), male sex (p=0.015), age (p=0.033), and bileaflet MVP (p=0.036). NLR was associated with absolute PVC burden (R2 0.08, p=0.023) and cVE (median [IQR] 3.1 [1.6 - 5.8]), versus without cVE (1.7 [1.6-3.1], p=0.044). An NLR of 5.6 yielded 50% sensitivity and 90% specificity for PVC burden >1% (AUC 0.69). No significant association was found between PLR and PVC burden or cVE. Conclusions: NLR is associated with PVC burden and complex ventricular ectopy in MVP, suggesting that inflammation is a significant factor in the pathogenesis of ventricular arrhythmia in this condition.