Title:The Predictive Value of Monocyte-to-HDL Cholesterol Ratio in Patients with Dilated Cardiomyopathy and Associated Pulmonary Hypertension
Volume: 23
Issue: 4
Author(s): Fengfeng Deng*, Jianqi Sun, Lixia Liu, Mingfa Zhang, Xin Wang, Chenting Zhan, Cunxin Qiu, Jianping Hu and Leiming Xia*
Affiliation:
- Department of Cardiovascular Medicine, Huangshan City People's Hospital, HuangShan, Anhui, China
- Department
of Hematology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- School of Basic Medical Sciences, Xinjiang Second Medical College, Karamay, Xinjiang, China
Keywords:
Pulmonary hypertension, dilated cardiomyopathy, monocyte to high-density lipoprotein cholesterol ratio, pulmonary artery systolic pressure, left ventricular ejection fraction, New York heart association (NYHA).
Abstract:
Background: Pulmonary Hypertension (PH) is a significant contributor to cardiac mortality
in Dilated Cardiomyopathy (DCM) patients. Inflammatory processes and oxidative stress
play pivotal roles in the advancement of Pulmonary Hypertension (PH). The Monocyte-
to-High-Density-Lipoprotein Cholesterol Ratio (MHR), a newly identified biomarker indicative
of inflammatory and oxidative stress, has not been extensively researched in the context of
pulmonary hypertension, especially within the scope of dilated cardiomyopathy.
Objectives: Given the reason mentioned above, our research explores the correlation between the
MHR and the severity of PH in patients suffering from DCM.
Methods: In this study, we conducted a retrospective review of medical data from 107 individuals
diagnosed with non-ischemic DCM, evaluating their clinical profiles, biochemical indicators,
MHR, and echocardiographic parameters. We analyzed the relationships between Pulmonary Arterial
Systolic Pressure (PASP) and the Ejection Fraction of the Left Ventricle (LVEF). Utilizing logistic
regression analysis, we determined the predictors of PH.
Results and Discussion: Findings indicated that the DCM-PH group exhibited a significantly larger
male population and elevated New York Heart Association (NYHA) classification scores (both
with p-values <0.001 and 0.01, respectively) compared to the DCM-only group. A positive association
was observed between the PASP and parameters, such as the Dimensions of the Left Atrium
(LAD) and Left Ventricle in Systole (LVDs), Monocyte (M) levels, Direct Bilirubin (DB), and
MHR. Conversely, an inverse relationship was noted with serum lipid profiles, including Total
Cholesterol (TC), HDL Cholesterol (HDL-c), and apolipoprotein A1. LVEF demonstrated positive
linkage with the same lipid profiles and the Left Ventricular Posterior Wall Thickness
(LVPWT) yet showed negative correlations with the NYHA classification, Red Blood Cell Distribution
Width Standard Deviation (RDW-SD), Total Bilirubin (TB), Direct Bilirubin (DB), and dimensions
of the left ventricle in diastole and systole, as well as MHR. Through logistic regression
analysis, several factors were recognized as significant predictors for the severity of PH within the
DCM cohort, with weight (OR1.20, CI 1.022-1.409, p=0.026), RDW-SD (OR1.988, CI
1.015-3.895, p=0.045), LVPW (OR3.577, CI 1.307-9.792, p=0.013), LVDd (OR1.333, CI
1.058-1.680, p=0.015), MHR (OR3.575, CI 1.502-8.506, p=0.032), and TB (OR1.416, CI
1.014-1.979, p=0.041) showing positive associations, while apoB (OR0.001 CI0.001-0.824,
p=0.045) exhibiting negative associations, all with p-values <0.05.
Conclusion: Higher MHR and LVD correlate with increased PASP and reduced LVEF in DCMPH
patients. MHR and LVPW are independent predictors of PH severity, indicating their potential
as novel severity markers in DCM-related PH.
