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image of The Predictive Value of Monocyte-to-HDL Cholesterol Ratio in Patients with Dilated Cardiomyopathy and Associated Pulmonary Hypertension

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.

Objective

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

Findings indicated that the DCM-PH group exhibited a significantly larger male population and elevated New York Heart Association (NYHA) classification scores (both with -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, =0.026), RDW-SD (OR1.988, CI 1.015-3.895, =0.045), LVPW (OR3.577, CI 1.307-9.792, =0.013), LVDd (OR1.333, CI 1.058-1.680, =0.015), MHR (OR3.575, CI 1.502-8.506, =0.032), and TB (OR1.416, CI 1.014-1.979, =0.041) showing positive associations, while apoB (OR0.001 CI0.001-0.824, =0.045) exhibiting negative associations, all with -values <0.05.

Conclusion

Higher MHR and LVD correlate with increased PASP and reduced LVEF in DCM-PH patients. MHR and LVPW are independent predictors of PH severity, indicating their potential as novel severity markers in DCM-related PH.

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2025-09-03
2025-09-09

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References

  1. Papadimitriou L. Hamo C.E. Butler J. Heart failure guidelines on pharmacotherapy. Handb. Exp. Pharmacol. 2017 243 109 129 10.1007/164_2017_24 28451824
    [Google Scholar]
  2. Gheorghiade M. Vaduganathan M. Fonarow G.C. Bonow R.O. Rehospitalization for heart failure: Problems and perspectives. J. Am. Coll. Cardiol. 2013 61 4 391 403 10.1016/j.jacc.2012.09.038 23219302
    [Google Scholar]
  3. Berthelot E. Bailly M.T. Hatimi S.E. Robard I. Rezgui H. Bouchachi A. Montani D. Sitbon O. Chemla D. Assayag P. Pulmonary hypertension due to left heart disease. Arch. Cardiovasc. Dis. 2017 110 6-7 420 431 10.1016/j.acvd.2017.01.010 28411107
    [Google Scholar]
  4. Guazzi M. Naeije R. Pulmonary hypertension in heart failure. J. Am. Coll. Cardiol. 2017 69 13 1718 1734 10.1016/j.jacc.2017.01.051 28359519
    [Google Scholar]
  5. Santas E. de la Espriella-Juan R. Mollar A. Valero E. Miñana G. Sanchis J. Chorro F.J. Núñez J. Echocardiographic pulmonary artery pressure estimation and heart failure rehospitalization burden in patients with acute heart failure. Int. J. Cardiol. 2017 241 407 410 10.1016/j.ijcard.2017.04.055 28455131
    [Google Scholar]
  6. Humbert M. Kovacs G. Hoeper M.M. Badagliacca R. Berger R.M.F. Brida M. Carlsen J. Coats A.J.S. Escribano-Subias P. Ferrari P. Ferreira D.S. Ghofrani H.A. Giannakoulas G. Kiely D.G. Mayer E. Meszaros G. Nagavci B. Olsson K.M. Pepke-Zaba J. Quint J.K. Rådegran G. Simonneau G. Sitbon O. Tonia T. Toshner M. Vachiery J.L. Vonk Noordegraaf A. Delcroix M. Rosenkranz S. ESC/ERS Scientific Document Group 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur. Respir. J. 2023 61 1 2200879 10.1183/13993003.00879‑2022 36028254
    [Google Scholar]
  7. Weitsman T. Weisz G. Farkash R. Klutstein M. Butnaru A. Rosenmann D. Hasin T. Pulmonary hypertension with left heart disease: Prevalence, temporal shifts in etiologies and outcome. Am. J. Med. 2017 130 11 1272 1279 10.1016/j.amjmed.2017.05.003 28552430
    [Google Scholar]
  8. Vachiéry J.L. Tedford R.J. Rosenkranz S. Palazzini M. Lang I. Guazzi M. Coghlan G. Chazova I. De Marco T. Pulmonary hypertension due to left heart disease. Eur. Respir. J. 2019 53 1 1801897 10.1183/13993003.01897‑2018 30545974
    [Google Scholar]
  9. Caravita S. Faini A. Carolino D’Araujo S. Dewachter C. Chomette L. Bondue A. Naeije R. Parati G. Vachiéry J.L. Clinical phenotypes and outcomes of pulmonary hypertension due to left heart disease: Role of the pre-capillary component. PLoS One 2018 13 6 e0199164 10.1371/journal.pone.0199164 29920539
    [Google Scholar]
  10. Plácido R. Cortez-Dias N. Robalo Martins S. Almeida A.G. Calisto C. Gonçalves S. Sadoune M. Nunes Diogo A. Mebazaa A. Pinto F.J. Prognostic stratification in pulmonary hypertension: A multi-biomarker approach. Rev Port Cardiol 2017 36 2 111 125 10.1016/j.repce.2016.12.001 28117181
    [Google Scholar]
  11. Geenen L.W. Baggen V.J.M. Koudstaal T. Boomars K.A. Eindhoven J.A. Boersma E. Roos-Hesselink J.W. van den Bosch A.E. The prognostic value of various biomarkers in adults with pulmonary hypertension: A multi-biomarker approach. Am. Heart J. 2019 208 91 99 10.1016/j.ahj.2018.11.001 30580131
    [Google Scholar]
  12. Dziewięcka E. Wiśniowska-Śmiałek S. Karabinowska A. Holcman K. Gliniak M. Winiarczyk M. Karapetyan A. Kaciczak M. Podolec P. Kostkiewicz M. Hlawaty M. Leśniak-Sobelga A. Rubiś P. Relationships between pulmonary hypertension risk, clinical profiles, and outcomes in dilated cardiomyopathy. J. Clin. Med. 2020 9 6 1660 10.3390/jcm9061660 32492830
    [Google Scholar]
  13. Abramson S.V. Burke J.F. Kelly J.J. Jr Kitchen J.G. III Dougherty M.J. Yih D.F. McGeehin F.C. III Shuck J.W. Phiambolis T.P. Pulmonary hypertension predicts mortality and morbidity in patients with dilated cardiomyopathy. Ann. Intern. Med. 1992 116 11 888 895 10.7326/0003‑4819‑116‑11‑888 1580444
    [Google Scholar]
  14. Fayyaz A.U. Edwards W.D. Maleszewski J.J. Konik E.A. DuBrock H.M. Borlaug B.A. Frantz R.P. Jenkins S.M. Redfield M.M. Global pulmonary vascular remodeling in pulmonary hypertension associated with heart failure and preserved or reduced ejection fraction. Circulation 2018 137 17 1796 1810 10.1161/CIRCULATIONAHA.117.031608 29246894
    [Google Scholar]
  15. Kanbay M. Solak Y. Unal H.U. Kurt Y.G. Gok M. Cetinkaya H. Karaman M. Oguz Y. Eyileten T. Vural A. Covic A. Goldsmith D. Turak O. Yilmaz M.I. Monocyte count/HDL cholesterol ratio and cardiovascular events in patients with chronic kidney disease. Int. Urol. Nephrol. 2014 46 8 1619 1625 10.1007/s11255‑014‑0730‑1 24853998
    [Google Scholar]
  16. Canpolat U. Aytemir K. Yorgun H. Şahiner L. Kaya E.B. Çay S. Topaloğlu S. Aras D. Oto A. The role of preprocedural monocyte-to-high-density lipoprotein ratio in prediction of atrial fibrillation recurrence after cryoballoon-based catheter ablation. Europace 2015 17 12 1807 1815 10.1093/europace/euu291 25995388
    [Google Scholar]
  17. Nagueh S.F. Smiseth O.A. Appleton C.P. Byrd B.F. III Dokainish H. Edvardsen T. Flachskampf F.A. Gillebert T.C. Klein A.L. Lancellotti P. Marino P. Oh J.K. Popescu B.A. Waggoner A.D. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J. Am. Soc. Echocardiogr. 2016 29 4 277 314 10.1016/j.echo.2016.01.011 27037982
    [Google Scholar]
  18. Lambert J.M. Lopez E.F. Lindsey M.L. Macrophage roles following myocardial infarction. Int. J. Cardiol. 2008 130 2 147 158 10.1016/j.ijcard.2008.04.059 18656272
    [Google Scholar]
  19. Chung K. Strange G. Codde J. Celermajer D. Scalia G.M. Playford D. Left heart disease and pulmonary hypertension: Are we seeing the full picture? Heart Lung Circ. 2018 27 3 301 309 10.1016/j.hlc.2017.09.015 29102471
    [Google Scholar]
  20. Lundgren J. Rådegran G. Pathophysiology and potential treatments of pulmonary hypertension due to systolic left heart failure. Acta Physiol. (Oxf.) 2014 211 2 314 333 10.1111/apha.12295 24703457
    [Google Scholar]
  21. Kainuma S. Taniguchi K. Toda K. Funatsu T. Kondoh H. Nishino M. Daimon T. Sawa Y. Pulmonary hypertension predicts adverse cardiac events after restrictive mitral annuloplasty for severe functional mitral regurgitation. J. Thorac. Cardiovasc. Surg. 2011 142 4 783 792 10.1016/j.jtcvs.2010.11.031 21397266
    [Google Scholar]
  22. Kannel W.B. Dawber T.R. Friedman G.D. Glennon W.E. McNamara P.M. Risk factors in coronary heart disease. An evaluation of several serum lipids as predictors of coronary heart disease, The Framingham study. Ann. Intern. Med. 1964 61 5_Part_1 888 899 10.7326/0003‑4819‑61‑5‑888 14233810
    [Google Scholar]
  23. Watanabe H. Tanabe N. Yagihara N. Watanabe T. Aizawa Y. Kodama M. Association between lipid profile and risk of atrial fibrillation. Circ. J. 2011 75 12 2767 2774 10.1253/circj.CJ‑11‑0780 21914959
    [Google Scholar]
  24. Annoura M. Ogawa M. Kumagai K. Zhang B. Saku K. Arakawa K. Cholesterol paradox in patients with paroxysmal atrial fibrillation. Cardiology 1999 92 1 21 27 10.1159/000006942 10640793
    [Google Scholar]
  25. Rohrer L. Ohnsorg P.M. Lehner M. Landolt F. Rinninger F. von Eckardstein A. High-density lipoprotein transport through aortic endothelial cells involves scavenger receptor BI and ATP-binding cassette transporter G1. Circ. Res. 2009 104 10 1142 1150 10.1161/CIRCRESAHA.108.190587 19372466
    [Google Scholar]
  26. Nofer J.R. van der Giet M. Tölle M. Wolinska I. von Wnuck Lipinski K. Baba H.A. Tietge U.J. Gödecke A. Ishii I. Kleuser B. Schäfers M. Fobker M. Zidek W. Assmann G. Chun J. Levkau B. HDL induces NO-dependent vasorelaxation via the lysophospholipid receptor S1P3. J. Clin. Invest. 2004 113 4 569 581 10.1172/JCI200418004 14966566
    [Google Scholar]
  27. Baker P.W. Rye K.A. Gamble J.R. Vadas M.A. Barter P.J. Ability of reconstituted high density lipoproteins to inhibit cytokine-induced expression of vascular cell adhesion molecule-1 in human umbilical vein endothelial cells. J. Lipid Res. 1999 40 2 345 353 10.1016/S0022‑2275(20)33375‑7 9925665
    [Google Scholar]
  28. Calkin A.C. Drew B.G. Ono A. Duffy S.J. Gordon M.V. Schoenwaelder S.M. Sviridov D. Cooper M.E. Kingwell B.A. Jackson S.P. Reconstituted high-density lipoprotein attenuates platelet function in individuals with type 2 diabetes mellitus by promoting cholesterol efflux. Circulation 2009 120 21 2095 2104 10.1161/CIRCULATIONAHA.109.870709 19901191
    [Google Scholar]
  29. Calabresi L. Gomaraschi M. Franceschini G. Endothelial protection by high-density lipoproteins: From bench to bedside. Arterioscler. Thromb. Vasc. Biol. 2003 23 10 1724 1731 10.1161/01.ATV.0000094961.74697.54 12969988
    [Google Scholar]
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The Predictive Value of Monocyte-to-HDL Cholesterol Ratio in Patients with Dilated Cardiomyopathy and Associated Pulmonary Hypertension
Bentham Science Publishers ; https://doi.org/10.2174/0118715257294388250326034612
/content/journals/chamc/10.2174/0118715257294388250326034612
/content/journals/chamc/10.2174/0118715257294388250326034612
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  • Article Type:     Research Article
Keywords: Pulmonary hypertension ; monocyte to high-density lipoprotein cholesterol ratio ; dilated cardiomyopathy ; pulmonary artery systolic pressure ; left ventricular ejection fraction

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