The Relationship between Neutrophil/Lymphocyte Ratio and Calcific Aortic Stenosis

Abstract

The role of inflammation in fibrotic and calcific processes of atherosclerosis and aortic stenosis (AS) is similar. Furthermore, a relationship between systemic inflammation and heart failure has been well demonstrated. Recently, neutrophil/lymphocyte ratio (NLR) has been proposed as a predictive marker of systemic inflammation. We investigated the association of NLR with the severity of calcific AS and left ventricular (LV) systolic dysfunction in patients with severe calcific AS. A total of 96 patients with calcific AS were included in this retrospective study from 2011 to 2013. The severity of AS was graded according to the transaortic mean pressure gradient. The patients were divided into 3 groups as mild-to-moderate AS, severe AS with normal left ventricular ejection fraction (LVEF), and severe AS with reduced LVEF (mean gradient >40mmHg and LVEF <50%). Neutrophil/lymphocyte ratio was significantly higher in severe calcific AS with reduced LVEF group than the other 2 groups (3.94±0.88, P<0.001). In addition, NLR was higher in severe AS with normal LVEF group than mild-to-moderate AS group (2.69±1.00 vs. 2.05±0.64, P=0.008). There was a statistically significant correlation between NLR and both transaortic mean pressure gradient and aortic valve peak velocity in patients with mild-to-severe AS with normal LVEF (n=81; r=0.369, P<0.001; r=0.290, P=0.004; respectively). Increased NLR is related to the severity of calcific AS and LV systolic dysfunction in patients with severe calcific AS.