Correlation Analysis Of Neutrophil To Lymphocyte Ratio And Cardiac Structure And Function In Heart Failure With Preserved Ejection Fraction

Objective: To discussion the contaction between the ratio of absolute value of neutrophil to lymphocyte and the cardiac structure and function of ejection fraction reserved heart failure（HFp EF）.Methods: A total of 501 HFp EF patients diagnosed with clinical symptoms and signs of heart failure in ward 1,Department of Geriatrics,First Hospital of Lanzhou University from 2015 to 2019 were selected.According to inclusion and exclusion criteria,HFp EF group（n=225 cases）and healthy control group（n=171 cases）were included in the same period.Clinical data of the patients were recorded,including blood routine test,biochemical analysis,thyroid function,N-Terminal pro B-type Natriuretic Peptide（NT-pro BNP）and echocardio-graphy and other related indexes.Correlation analysis,Binary Logistic regression analysis and ROC curve analysis were used to evaluate the correlation between neutrophil to lymphocyte ratio（NLR）and cardiac structure and function of HFp EF patients,and to determine whether NLR has diagnostic value for HFp EF.Results:1)General information: HFp EF group was mostly elderly women,with higher body mass index,blood pressure and heart rate than the control group,accompanied by abnormal liver function,renal function and blood glucose,and chronic comorbidities such as atrial fibrillation,hypertension,coronary heart disease and obesity.2)Relationship between NLR and left heart structure: The NLR,LVIDd,LVIDs,IVSTd,IVSTs,PWTd,PWTs,RWT,LVMi-L,LVEDV,LAD,LADi,LAV and LAVi values in HFp EF group were higher than those in control group.NLR was positively correlated with IVSTd,IVSTs,PWTd,PWTs,RWT,LVMi-L,LAD,LADi and LAV.Multi-factors linear regression analysis demonstated that NLR was independently correlated with PWTd,PWTs,LVMi-L,LAD,LADi and LAV.3)The relationship between NLR and left heart function: E,A,DT,E/E’L,E/E’L,E/E’S,E/E’,E/FPV in HFp EF group were higher than those in control group,and NLR was positively correlated with E,E/E’L,E/E’S,E/E’ and FPV.Multi-factors linear regression analysis demonstated that NLR was independently correlated with E,E/E’L,E/E’S,E/E’.4)The relationship between NLR and right heart structure: The values of RV-FWD,RV-FWS,RV-D1,RV-D2,RV-D3,RVOT1,RVOT2,RA-D1,RA-D2,AND RA-A in HFp EF group were higher than those in control group,but there was no correlation between NLR and right heart related indexes.5)The relationship between NLR and pulmonary artery diameter and pulmonary artery systolic pressure: PA and PASP in HFp EF group were higher than those in control group,and multi-factors linear regression analysis demonstated that NLR was independently correlated with PASP.6)Predictive value of NLR for HFp EF: Binary Logistic analysis showed that NLR,NTpro BNP,RWT,LVMi,LAVi,E’L,E/E’,E’S,PASP,TR all had independent predictive value for HFp EF.ROC curve analysis showed that the sensitivity and specificity of NLR in the diagnosis of HFp EF were 69.3% and 59.1%,respectively.The optimal cutoff value was 1.7,and the area under the curve combined with the above indexes and NLR was the largest（AUC: 0.99）,with a sensitivity of 95.1%.Conclusion: HFp EF patients have higher NLR value,and NLR affects HFp EF ventricular wall thickness,atrial size,volume and ventricular diastolic function.NLR has certain diagnostic value for HFp EF,and the optimal truncation value is 1.7.