Neutrophil to lymphocyte ratio as noninvasive predictor of pulmonary vascular resistance increase in congestive heart failure patients: Single-center preliminary report

Adv Clin Exp Med. 2020 Nov;29(11):1313-1317. doi: 10.17219/acem/126292.


Background: Nowadays, heart failure (HF) is a significant health problem due to steady increase in diagnosis, unpredictable acute decompensations and high mortality rate. Early risk stratifications of clinical deterioration are essential in preventing life-threatening events and ensuring proper patients management. Increased neutrophil to lymphocytes ratio (NTLR) above 6 is associated with the risk of re-hospitalizations and increased mortality.

Objectives: To compare NTLR and clinical, laboratory and hemodynamic results obtained from patients re-hospitalized within six-month intervals due to HF decompensation.

Material and methods: We evaluated 41 patients (n = 36 males (87%) and n = 5 females (13%), mean age 50 ±10 years) admitted to our hospital at least twice within six-month interval due to decompensation of chronic heart failure (CHF) between 2017 and 2019. All patients were divided into 2 groups depending on the NTLR values.

Results: There was no death in presented group during the observational time. We observed a significant difference in cardiac index (CI) - 2.4 ±0.5 compared to 2.6 ±0.6 L/m2/min - between the 1st and 2nd admission (p = 0.0356). The right ventricle systolic pressure (RVSP) results related to NTLR level revealed significant difference (43 ±14 mm Hg compared to 59 ±21 mm Hg, p = 0.0438). We observed a significant increase of pulmonary vascular resistance (PVR) values (175 ±106 compared to 438 ±300 dyn*s*cm-5, p = 0.0386) in patients with NTLR above 6.

Conclusions: Neutrophil to lymphocyte ratio may be an easy and suitable tool for monitoring of the HF progression. According to our study, the ratio correlates with PVR and RVSP increase.

Keywords: heart failure; neutrophils; pulmonary hypertension; pulmonary vascular resistance.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Female
  • Heart Failure* / diagnosis
  • Hemodynamics
  • Humans
  • Lymphocytes*
  • Male
  • Middle Aged
  • Neutrophils*
  • Vascular Resistance