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Neutrophil-to-lymphocyte ratio as a predictive and prognostic marker in children with dilated cardiomyopathy

Published online by Cambridge University Press:  17 March 2023

Mai Ahmed ,
Doaa El Amrousy Open the ORCID record for Doaa El Amrousy [Opens in a new window] ,
Hossam Hodeib  and
Shimaa Elnemr
Mai Ahmed
Affiliation:
Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Doaa El Amrousy*
Affiliation:
Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Hossam Hodeib
Affiliation:
Clinical Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Shimaa Elnemr
Affiliation:
Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
*
Author for correspondence: Doaa El Amrousy, Pediatric Department, Faculty of Medicine, Tanta University, 6 Motasem Street, Tanta, Egypt. Tel: +201289022229; Fax: +20403282277. E-mail: doaamoha@yahoo.com
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Abstract

Objectives:

We aimed to evaluate neutrophil-to-lymphocyte ratio in children with acute heart failure due to dilated cardiomyopathy, to assess the predictive and prognostic values of neutrophil-to-lymphocyte ratio, and to correlate its levels with brain natriuretic peptide and other various data in these patients.

Method:

We included 50 children with acute heart failure due to dilated cardiomyopathy as the patient group. Fifty healthy children of matched age and sex served as the control group. Patients were evaluated clinically and by echocardiography. A complete blood count with differentiation to evaluate neutrophil-to-lymphocyte ratio was done, and the serum level of brain natriuretic peptide was also measured. All patients were followed up for death or readmission for a period of one year.

Results:

Neutrophil-to-lymphocyte ratio was significantly higher in patient group as compared to the control group. Neutrophil-to-lymphocyte ratio was significantly increased in patients with higher severity of heart failure. There was a significant increase in neutrophil-to-lymphocyte ratio in patients with bad prognoses compared to those with good prognoses. There was a significant positive correlation between neutrophil-to-lymphocyte ratio and both brain natriuretic peptide and clinical stage of heart failure while there was a significant negative correlation between neutrophil-to-lymphocyte ratio and left ventricular systolic function. The best cut-off of neutrophil-to-lymphocyte ratio to predict adverse outcomes in children with dilated cardiomyopathy was >3.6 with 87% sensitivity and 79% specificity. The cut-off of neutrophil-to-lymphocyte ratio to predict patients who will not respond to conventional treatment was ≥3.85 with 85% sensitivity and 100% specificity.

Conclusion:

Neutrophil-to-lymphocyte ratio is a cheap good predictive and prognostic biomarker in children with dilated cardiomyopathy.

Keywords

Dilated cardiomyopathyneutrophil-to-lymphocyte ratioB-type natriuretic peptidepredictive and prognosticpaediatric heart failure
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 12 , December 2023 , pp. 2493 - 2497
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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