Author + information
Heart failure (HF), which is a major cardiovascular health problem, has still a poor prognosis despite advances in its management. Several studies suggested that inflammation has an important role in HF progression. However, the location of inflammation in diagnosis and treatment of patients with HF is still unclear. Therefore, we aimed to compare inflammatory markers in patients with ischemic and non-ischemic HF.
This study included 46 ischemic HF (33 male, age 69±10 years) and 55 non-ischemic HF (35 male, age 61±11 years) patients who had functional class I-II, asymptomatic, low left ventricular ejection fraction (LV EF <40%). In addition, there was no coronary artery disease or angiographycally significant stenosis (≥50% in diameter) in non-ischemic HF patients. An age, sex-matched control group was composed of 40 (17 male, age 58±13 years) patients. We evaluated clinical and laboratory characteristics which are associated with inflammatory process such as red blood cell distribution width (RDW), white blood cells (WBC), neutrophil-to-lymphocyte counts (NLR), uric acit and high sensivity C reactive protein (Hs CRP). Echocardiography was performed. The left atrial size, LV diameter and volumes, wall thickness were measured. LV EF was calculated by Simpson's method.
Age, diabetes mellitus, hyperlipidemia, systolic and diastolic blood pressure were significantly higher in HF group when compared with control group. LV EF (29.6±4.8 vs 31±5, p=0.20), diameters and volumes was similar between ischemic and non ischemic HF groups. According to control group, RDW (15.8±1.9 vs 15.5±1.8 vs 14±1.5, p<0.05), neutrophil-to-lymphocit ratio [348 (169-768) vs 269 (65-722) vs 177 (58-268), p<0.05], uric acid (6.9±1.9 vs 6.1±1.8 vs 4.5±1.3 mg/dl, p<0.05) levels were significantly higher in heart failure groups., Hs CRP levels [18.8 (1.1-92.7) vs 8.7 (1-42) mg/L, p<0.05], NLR [348 (169-768) vs 269 (65-722), p<0.05] were significantly higher in ischemic HF group when compared with non-ischemic HF group.
Our findings show that markers associated with inflammation in HF, especially increase in patients with ischemic HF. Therefore, we believe that the inflammatory process should be evaluated in diagnosis and treatment of patients with HF. However, this result needs to be validated in large-sized studies.
Key words: Heart Failure, Inflammation, C reactive protein.