Share this page on LinkedIn
Share This Page on Google+
Share This Page on Twitter
tell someone about this page print this page
You are here: Contents > 2016 > Volume 25 Number 2 March 2016 > MITRAL VALVE DISEASE > The Presence of Left Atrial Thrombus is Associated with the Neutrophil-to-Lymphocyte Ratio in Patients with Rheumatic Mitral Valve Stenosis

The Presence of Left Atrial Thrombus is Associated with the Neutrophil-to-Lymphocyte Ratio in Patients with Rheumatic Mitral Valve Stenosis

Ender Ozal1, Erdal Belen2, Ender Ozgun Cakmak3, Gunduz Durmus4, Hamdi Pusuroglu4

1Department of Cardiology, Pendik State Hospital, Istanbul, 2Department of Cardiology, Okmeydanı Training and Research Hospital, Istanbul, 3Kartal Kosuyolu High Speciality Education and Research Hospital, Istanbul, 4Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey

Background and aim of the study: Rheumatic mitral valve stenosis (RMVS)-induced left atrial thrombus (LAT) and embolic complications may have clinically devastating consequences. Stasis in the left atrium induced by valvular obstruction is a major factor in the development of thrombus. However, the development of thrombus may not be solely associated with stasis, as it is known that the inflammatory process increases the tendency for thrombosis. The study aim was to examine the relationship between the neutrophil-to-lymphocyte ratio (NLR), an indicator of inflammation, and the existence of LAT.

Methods: A total of 313 consecutive patients with RMVS and mitral valve area (MVA) <2 cm2 was included in this cross-sectional study. Patients were allocated to two groups with or without LAT using transthoracic and transesophageal echocardiography. Routine biochemical analyses and electrocardiographic examinations were also carried out. The NLR was calculated utilizing blood count analysis.

Results: The presence of LAT was identified in 78 RMVS patients (24.9%). No significant differences in terms of age, gender, body mass index were found between the groups with and without LAT. On echocardiographic examination, a higher mean gradient and left atrial diameter, as well as a smaller MVA, were determined in patients with LAT (p<0.001). In those patients with LAT, higher C-reactive protein levels and higher leukocyte and neutrophil counts (p <0.001) and lower lymphocyte counts were noted (p = 0.001). The NLR was shown to be higher in patients with LAT (p <0.001). Multivariate regression analysis showed that the relationship between LAT and a high NLR continued independently (OR 5.3; 95% CI 2.9-9.4; p <0.001).

Conclusion: The NLR is an easily obtained, low-cost and easily repeated parameter that seems effective for identifying RMVS patients who are at high risk of developing LAT.

The Journal of Heart Valve Disease 2016;25:198-202

The Presence of Left Atrial Thrombus is Associated with the Neutrophil-to-Lymphocyte Ratio in Patients with Rheumatic Mitral Valve Stenosis

Click the above hyperlink to view the article, right click (Ctrl click on a Mac) to open in a new browser window or tab.

Purchase this Article

Please click the button below to purchase this article. Single article purchases are provided at $50.00 per article. Upon clicking the button below, single article user account subscription details are requested and, upon successful payment, a single article user account is created. Single articles are availble in your account for seven days after purchase.