Relationship Between Neutrophil-Lymphocyte Ratio Value And Severity of Mitral Stenosis Due to Rheumatic Heart Disease in Outpatients at H. Adam Malik General Hospital Medan

Aziz Achmad; Zainal Safri; Teuku Bob Haykal; Abdullah Afif Siregar; Nizam Zikri Akbar; Tengku Winda Ardini; Cut Aryfa Andra; Anggia Chairuddin Lubis

doi:10.71197/jsocmed.v3i12.183

Relationship Between Neutrophil-Lymphocyte Ratio Value And Severity of Mitral Stenosis Due to Rheumatic Heart Disease in Outpatients at H. Adam Malik General Hospital Medan

Aziz Achmad
Cardiology Department, Faculty of Medicine, Universitas Sumatera Utara
Zainal Safri
Cardiology Department, Faculty of Medicine, Universitas Sumatera Utara
Teuku Bob Haykal
Cardiology Department, Faculty of Medicine, Universitas Sumatera Utara
Abdullah Afif Siregar
Cardiology Department, Faculty of Medicine, Universitas Sumatera Utara
Nizam Zikri Akbar
Cardiology Department, Faculty of Medicine, Universitas Sumatera Utara
Tengku Winda Ardini
Cardiology Department, Faculty of Medicine, Universitas Sumatera Utara
Cut Aryfa Andra
Cardiology Department, Faculty of Medicine, Universitas Sumatera Utara
Anggia Chairuddin Lubis
Cardiology Department, Faculty of Medicine, Universitas Sumatera Utara

Abstract

Introduction: Mitral stenosis (MS) is a heart valve disease characterized by narrowing of the mitral valve, commonly caused by rheumatic heart disease. Accurate evaluation of MS severity is crucial for management, with echocardiography being the gold standard. The Neutrophil-Lymphocyte Ratio (NLR), reflecting inflammation, may correlate with MS severity. This study aims to assess the relationship between NLR values and MS severity due to rheumatic heart disease.

Method: This cross-sectional study was conducted at H. Adam Malik General Hospital Medan from January 2023 until the required sample size was achieved. Patients diagnosed with MS by echocardiography based on the American Society of Echocardiography (ASE) criteria were included. Echocardiographic parameters such as mitral valve area (MVA) and mean pressure gradient (MV mean PG), along with blood NLR values, were analyzed for associations. Statistical significance was set at P < 0.05.

Results: Significant differences in NLR values were observed between mild-to-moderate MS (1.93; 0.82–10.64) and severe MS (3.56; 1.81–13.08) (P = 0.0001, Mann-Whitney test). An NLR threshold of 2.91 predicted severe MS with 82% sensitivity and 81.8% specificity (P = 0.0001; AUC 0.856; 95% CI 0.772–0.940).

Conclusion: NLR strongly correlates with MS severity and serves as a reliable predictor for severe MS in patients with rheumatic heart disease. NLR offers a simple, cost-effective tool for assessing MS severity, complementing echocardiography in clinical practice.

Similar Articles

M. Rizky Priyanka Asepty, Anggia Chairuddin Lubis, Zulfikli Mukhtar, Predictors of Success of Ablation Procedures in Patients with Non-Structural Premature Ventricular Contraction at Adam Malik Hospital , Journal of Society Medicine: Vol. 3 No. 9 (2024): September
Jessica Patricia Pangaribuan, Santi Syafril, Dian Anindita Lubis, Rahmad Isnanta, Imelda Rey, Effect of Glycemic Parameters on Mortality of Type 2 Diabetes Mellitus Patients with COVID-19 Infection in Haji Adam Malik Hospital Medan , Journal of Society Medicine: Vol. 2 No. 8 (2023): August
Clarisa Monica, Taufik Sungkar, Ilhamd, Correlation between Helicobacter Pylori Caga Antibody Serum and Gastric Premalignant Lesions in Helicobacter Pylori Patients , Journal of Society Medicine: Vol. 2 No. 10 (2023): October
Olivia Monica Deneuve, Andika Pradana, Amira P. Tarigan, The Relationship of Blood Eosinophils Levels with Degree of Exacerbation in COPD Patient at Usu General Hospital , Journal of Society Medicine: Vol. 3 No. 7 (2024): July
Yovita Belva Lokman, Dedy Dwi Putra, Setia Putra Tarigan, Ririe Fachrina Malisie, Thoracic CT Scan Image in Transudate and Exudate Pleural Effusion Cases at Haji Adam Malik General Hospital Medan in January - September 2024 , Journal of Society Medicine: Vol. 3 No. 12 (2024): December
Dalimunthe Dina A, Sisilia K Dewi, Cutaneous Disorder Associated Diabetes Mellitus , Journal of Society Medicine: Vol. 4 No. 1 (2025): January
Batian Lubis, Dis Bima P Purwaamidjaja, Mayang Indah Lestari, Faisal, Muhammad Husni Thamrin, Febri Akhmad Belinda, A Case Series of Bleeding Complication Post Percutaneous Dilatational Tracheostomy and Management , Journal of Society Medicine: Vol. 2 No. 12 (2023): December
Nengah Darmawan, Amira Permatasari Tarigan, Andika Pradana, Relationship Between Asthma Therapy Types, Pulmonary Function, and Asthma Control in Primary Healthcare Facilities in Medan , Journal of Society Medicine: Vol. 4 No. 2 (2025): February
Rizki amaliah Damanik, Andika Pradana, Pandiaman Pandia, Blood Eosinophil Count as a Predictor of Asthma Exacerbation , Journal of Society Medicine: Vol. 4 No. 2 (2025): February
Sri Bayani, Amira Permatasari Tarigan, Pandiaman Pandia, Rina Amelia, Budi Jefri, The Effect of Providing Education on the Use of Inhalers on Asthma Degrees Based on the Asthma Control Test (ACT) in Patients at Tanjungpura Hospital , Journal of Society Medicine: Vol. 3 No. 10 (2024): Oktober

<< < 4 5 6 7 8 9

You may also start an advanced similarity search for this article.

PDF

Published at

31. December 2024
https://doi.org/10.71197/jsocmed.v3i12.183
Issue:

Vol. 3 No. 12 (2024): December
Section:

Articles
Keywords:

Neutrophil to Lymphocyte Ratio Mitral Stenosis Rheumatic Heart Disease
References:

Carapetis JR, McDonald M, Wilson NJ. Acute rheumatic fever. The Lancet. 2005; 366: 155-168.

Davutoglu V, Celik A, Aksoy M. Contribution of selected serum inflammatory mediators to the progression of chronic rheumatic valve disease, subsequent valve calcification, and NYHA functional class. J Heart Valve Dis. 2005; 14: 251-256.

Shah SN, Sharma S. Mitral Stenosis. StatPearls. Treasure Island (FL): StatPearls Publishing. 2022; 1: 1-17

Elemary M, Elmeligy N, Tabl M, Elhameed A. Usefulness of novel hematologic inflammatory parameter: Neutrophil to lymphocyte ratio in patients with rheumatic valve diseases. Am J Res Commun. 2016; 4: 43-62.

Bhat T, Teli S, Rijal J, Bhat H, Raza M, Khoueiry G, et al. Neutrophil to lymphocyte ratio and cardiovascular diseases: a review. Expert Rev Cardiovasc Ther. 2013; 11: 55-59.

Guthrie GJK, Charles KA, Roxburgh CSD, Horgan PG, McMillan DC, Clarke SJ, et al. The systemic inflammation-based neutrophil-lymphocyte ratio: Experience in patients with cancer. Crit Rev Oncol Hematol. 2013; 88: 218-230.

Martins EC, Silveira Lda F, Viegas K, Beck AD, Fioravantti Júnior G, Cremonese RV, et al. Neutrophil-lymphocyte ratio in the early diagnosis of sepsis in an intensive care unit: a case-control study. Rev Bras Ter Intensiva. 2019; 31; 1-18.

Polat N, Yildiz A, Yuksel M, Bilik MZ, Aydin M, Acet H, et al. Association of neutrophil-lymphocyte ratio with the presence and severity of rheumatic mitral valve stenosis. Clin Appl Thromb Hemost. 2014; 20: 793-798.

Simpson MT, Kachel M, Neely RC, Miller J, Gonzalez T, Chan C, et al. Rheumatic heart disease in the developing world. Struct Heart. 2023; 7: 100-219.

Lilyasari O, Prakoso R, Kurniawati Y, Hidayat S, Saputra T, Anggraeni D, et al. Clinical profile and management of rheumatic heart disease in children and young adults at a tertiary cardiac center in Indonesia. Front Surg. 2020; 7: 47.

Kumar RK, Antunes MJ, Beaton A, Mirabel M, Nkomo VT, Okello E, et al. Contemporary diagnosis and management of rheumatic heart disease: implications for closing the gap: a scientific statement from the American Heart Association. Circulation. 2020; 142: 1-20.

Rahimtoola SH, Durairaj A, Mehra A, Nuno I. Current evaluation and management of patients with mitral stenosis. Circulation. 2002; 106: 1183-1188.

El Sabbagh A, Reddy YNV, Barros-Gomes S, Borlaug BA, Miranda WR, Pislaru SV, et al. Low-gradient severe mitral stenosis: Hemodynamic profiles, clinical characteristics, and outcomes. J Am Heart Assoc. 2019; 8: 1-15.

Desai CK, Orvarsson J, Stys A. Non-rheumatic mitral annular calcification as a cause of late-onset mitral stenosis. S D Med. 2019; 72: 535-536.

Brandes A. Rheumatic mitral valve stenosis and atrial fibrillation - Vicious twins. Int J Cardiol. 2024; 395: 131566.

Iung B, Leenhardt A, Extramiana F. Management of atrial fibrillation in patients with rheumatic mitral stenosis. Heart. 2018; 104: 1062-1068.

Poyraz E, Dinç Asarcıklı L, Kemaloğlu Öz T, Ünal Dayı Ş. Assessment of right ventricular systolic function with 3-dimensional speckle tracking echocardiography in isolated mild mitral stenosis. Anatol J Cardiol. 2023; 27: 71-77.

Maganti K, Rigolin VH, Sarano ME, Bonow RO. Valvular heart disease: diagnosis and management. Mayo Clin Proc. 2010; 85: 483-500.

Akboga MK, Akyel A, Sahinarslan A, Yayla C, Alsancak Y, Gokalp G, et al. Neutrophil-to-lymphocyte ratio is increased in patients with rheumatic mitral valve stenosis? Anatol J Cardiol. 2015; 15: 380-384.

Turak O, Özcan F, İşleyen A, Başar FN, Gül M, Yilmaz S, et al. Usefulness of neutrophil-to-lymphocyte ratio to predict in-hospital outcomes in infective endocarditis. Can J Cardiol. 2013; 29: 1672-1678.

Azab B, Zaher M, Weiserbs KF, Torbey E, Lacossiere K, Gaddam S, et al. Usefulness of neutrophil to lymphocyte ratio in predicting short- and long-term mortality after non-ST-elevation myocardial infarction. Am J Cardiol. 2010; 106: 470-476.

Manfrini O, Bugiardini R. Rheumatic fever and rheumatic heart disease. G Ital Cardiol. 2006; 7: 266-272.

Baysal E, Burak C, Cay S, Aksu T, Altintas B, Yaylak B, et al. The neutrophil to lymphocyte ratio is associated with severity of rheumatic mitral valve stenosis. J Blood Med. 2015; 151: 1-14.

Cho IJ, Jeong H, Chang HJ. Prognostic value of left atrial volume index in patients with rheumatic mitral stenosis. Clin Cardiol. 2021; 44: 364-370.

Balachandran P, Schaff HV, Lahr BD, Dearani JA, Suri RM, Greason KL. Preoperative left atrial volume index is associated with postoperative outcomes in mitral valve repair for chronic mitral regurgitation. J Thorac Cardiovasc Surg. 2020; 160: 661-672.

Varol E, Aksoy F, Ozaydin M, Erdogan D, Dogan A. Association between neutrophil-lymphocyte ratio and mitral annular calcification. Blood Coagul Fibrinolysis. 2014; 25: 557-560.

Öztürk D, Erturk M, Celik O, Ozyılmaz S, Akturk F, Cakmak HA, et al. The role of the neutrophil/lymphocyte ratio in patients with rheumatic mitral stenosis as an indicator of spontaneous echocardiographic contrast. Kardiol Pol. 2014; 72: 969-976.

Tian H, Jiang X, Duan G, Zhang L, Chen Y, Wang J, et al. Preoperative inflammatory markers predict postoperative clinical outcomes in patients undergoing heart valve surgery: A large-sample retrospective study. Front Immunol. 2023; 14: 115-9089.
Share:

Z

Achmad, A., Safri, Z., Haykal, T. B., Siregar, A. A., Akbar, N. Z., Ardini, T. W., … Lubis, A. C. (2024). Relationship Between Neutrophil-Lymphocyte Ratio Value And Severity of Mitral Stenosis Due to Rheumatic Heart Disease in Outpatients at H. Adam Malik General Hospital Medan. Journal of Society Medicine, 3(12), 379–388. https://doi.org/10.71197/jsocmed.v3i12.183