Relationship between mean platelet volume and mitral annular calcification

Severity of Mitral Valve Stenosis - Possible Relationships With Blood Oxidant Markers and Antioxidants

BACKGROUND

This study examined whether the severity of mitral valve stenosis (MVS) is associated with oxidative stress (OS) markers in the blood, and other hematological and clinicodemographic parameters.

METHODS AND RESULTS

This prospective study was conducted between March and May 2022. Seventy-five patients with newly diagnosed MVS (25 mild, 25 moderate, 25 severe) were included. Mild, moderate, and severe MVS was defined as MV area >2, 1.5-2, and <1.5 cm2, respectively. Various OS markers and laboratory parameters were determined in venous blood samples. For predictive analyses, 2 different analyses were performed to detect patients with severe MVS and those with moderate or severe (moderate/severe) MVS. Age (P=0.388) and sex (P=0.372) distribution were similar in the 3 groups. Multiple logistic regression analysis revealed that a high white blood cell (WBC) count (P=0.023) and high malondialdehyde (P=0.010), superoxide dismutase (SOD; P=0.008), and advanced oxidation protein products (AOPP; P=0.007) levels were independently associated with severe MVS. A low platelet count (P=0.030) and high malondialdehyde (P=0.018), SOD (P=0.008), and AOPP (P=0.001) levels were independently associated with having moderate/severe MVS. The best discriminatory factors for severe MVS were SOD (cut-off >315.5 ng/mL) and glutathione (cut-off >4.7 μmol/L).

CONCLUSIONS

MVS severity seems to be affected by oxidant markers (malondialdehyde and AOPP), antioxidant enzymes (SOD), and inflammation-related cells (WBC and platelets). Future studies are needed to examine these relationships in larger populations.

The value of inflammatory biomarkers in the occurrence and prognosis of sudden sensorineural hearing loss: a meta-analysis

OBJECTIVES

Sudden sensorineural hearing loss (SSNHL) is one of the common emergencies in otorhinolaryngology. Several studies have shown that chronic inflammation is associated with its onset and prognosis. However, the association between some inflammatory biomarkers and SSNHL is still unclear. Therefore, we conducted this meta-analysis to explore the value of inflammatory biomarkers in the occurrence and prognosis of SSNHL.

METHODS

Pubmed, Embase, Cochrane and Web of Science databases were searched comprehensively, the eligible literatures were screened out by formulating the inclusion criteria and exclusion criteria. After extracting sample size, mean and standard deviation, we performed meta-analysis with standardized mean deviation (SMD) and 95% confidence interval (CI) as effect sizes.

RESULTS

A total of 17 articles were included in this meta-analysis, including 2852 subjects, 1423 patients and 1429 healthy controls. The results of meta-analysis showed that the neutrophil-to-lymphocyte ratio (NLR) of the experimental group was significantly higher than the control group (SMD = 1.05, 95% CI 0.87-1.24, P < 0.001), the NLR of the recovery group was significantly lower than the unrecovered group (SMD = 0.68, 95% CI 0.27-1.08, P < 0.05); The platelet-to-lymphocyte ratio (PLR) of the experimental group was significantly higher than the control group (SMD = 0.55, 95% CI 0.34-0.76, P < 0.05), the PLR of the recovery group was significantly lower than the unrecovered group (SMD = 0.44, 95% CI 0.05-0.82, P < 0.05); The C-reactive protein-to-serum albumin ratio (CRP/Alb) of the experimental group was significantly higher than the control group (SMD = 0.39, 95% CI 0.04-0.74, P < 0.05).

CONCLUSIONS

The results showed that high NLR, PLR, and CRP/Alb indicated the occurrence of SSNHL, NLR and PLR could predict prognosis of SSNHL.

Extensive calcification of the mitral valve annulus in transcatheter aortic valve implants

 

OBJECTIVES

This study sought to report the calcification pattern of the mitral valve annulus and its implications for procedural and safety outcomes in transcatheter aortic valve implantation.

METHODS

Between November 2018 and September 2019, a total of 305 patients had transcatheter aortic valve implants at our institution. The extent of calcification of the mitral valve annulus was analysed, and the impact on safety outcomes was evaluated.

RESULTS

The prevalence of mitral annular calcification (MAC) was 43%. Calcification of the mitral valve annulus was either less than or at least one-third of the posterior annulus (34% and 32%), the whole posterior annulus (28%) or the extension to the attachment of the anterior leaflets (7%). Severe circumferential MAC revealed moderate paravalvular leaks in 5/8 (63%) patients and was associated with right branch bundle block [odds ratio (OR) 2.01 (0.39–3.06); P = 0.098] and low cardiac output [OR 3.12 (1.39–7.04); P = 0.033]. Subannular calcification at the anterolateral trigonum represented a risk factor for left ventricular outflow tract injury [OR 3.54 (1.38–8.27); P = 0.001] in balloon-expandable valves, associated with relevant rhythm disorders [OR 2.26 (1.17–5.65); P = 0.014] and female gender (7/8, 88%). The 30-day all-cause mortality in circumferential MAC reaching into the anterior annulus (grade IV) compared to patients with less MAC (grade I–III) was 13% vs 2% with a mean valve size of 24.6 vs 25.7 mm.

CONCLUSIONS

Extensive MAC was associated with moderate paravalvular leaks, with implications for the prosthesis size and survival in transcatheter aortic valve implants. In severe MAC, we recommend implanting oversized self-expandable prostheses, the goal being to reduce the risk of right branch bundle block and paravalvular leaks.

Subj collection

122, 125

Mean platelet volume and neutrophil to lymphocyte ratio in patients with tinnitus: a case-control study

INTRODUCTION

Different theories have been proposed on the etiology of tinnitus, including metabolic and audiologic causes. We suggest that mean platelet volume and neutrophil to lymphocyte ratio levels change in tinnitus, indicating microcirculatory disturbance and inflammatory process in the etiopathogenesis of tinnitus.

OBJECTIVES

We aimed to evaluate the mean platelet volume and neutrophil to lymphocyte ratio in patients with tinnitus in comparison to healthy controls.

METHODS

Retrospective case-control study. Two-hundred and eighty-seven patients aged 18-59 years and diagnosed with tinnitus in the Ear, Nose, and Throat Clinic between December 2014 and May 2017 (patient group) and 275 healthy individuals who applied for a hearing screening within the same time period (control group). Demographics, concomitant diseases, laboratory results, and audiometric data were recorded. Mean platelet volume and neutrophil to lymphocyte ratio were the outcome measures. Patients with hearing loss due to presbycusis or another reasons, and patients with anatomical disorders in the external and middle ear were excluded from the study by using physical examinations, pure audio audiometry results and radiological imaging. The upper age limit was set at 59 to exclude presbycusis patients.

RESULTS

The ratio of female patients was higher in patient group than control group (58.5%, n=168 vs. 49.4%, n=127; respectively; p=0.033). The mean age of patient group was significantly higher than those of control group (44.89±10.96 years and 38.37±10.65 years, respectively; p=0.001). The percentage of subjects with high mean platelet volume level was significantly higher in patient group than control group (9.4%, n=27, and 3.1%, n=8 respectively; p=0.008). The mean neutrophil to lymphocyte ratio was higher in patients with tinnitus than control group (1.95±1.02 and 1.67±0.57, p=0.012). A neutrophil to lymphocyte ratio level of 2.17 and above is associated with 1.991 times higher risk of tinnitus (odds ratio=1.99, 95% confidence interval 1.31-3.02).

CONCLUSION

High mean platelet volume and neutrophil to lymphocyte ratio values are associated with idiopathic tinnitus, suggesting the role of vascular pathologies in etiology of tinnitus. Tinnitus may be a sign of underlying systemic or local disorders. Therefore, patients with tinnitus should undergo detailed evaluation including hematological indices.

Mitral annular calcification is associated with atrial fibrillation and major cardiac adverse events in atrial fibrillation patients: A systematic review and meta-analysis

BACKGROUND

The incidence of atrial fibrillation (AF) varies from 5.4% to 47.1% in patients with mitral annulus calcification (MAC). We conducted a systematic review and meta-analysis on the association between MAC and AF, as well as the relation between MAC and major cardiac adverse events (MACEs) in AF patients.

METHODS

We conducted comprehensive search for literature on associations between MAC and AF using the following databases: MEDLINE, PubMed, Embase, and the Web of Science. The pooled odds ratio (OR) or relative risk and the corresponding 95% confidence intervals (CIs) were calculated to assess the relationship between MAC and AF, as well as the rates of MACEs in AF patients with or without MAC.

RESULTS

Thirteen studies met our eligibility criteria on associations between MAC and AF, including 6232 patients with MAC and 15,199 patients without MAC. Moreover, 5 studies met our eligibility criteria on the rates of MACEs in AF patients with or without MAC. The pooled analysis demonstrated a statistically significant increased risk of development of incident AF in patients with MAC than those without MAC (random effects OR: 2.34; 95% CI: 1.91, 2.85; P = .000). And the pooled analysis demonstrated a statistically significant increased risk of development of MACEs in AF patients with MAC (random effects OR: 2.34; 95% CI: 1.24, 4.41; P = .009).

CONCLUSION

MAC was independently associated with AF and AF patients with MAC were at greater risk for cardiovascular and cerebrovascular events.

Mean Platelet Volume Predicts Short-term Prognosis in Young Patients with St-segment Elevation Myocardial Infarction

Background: Acute ST-elevation myocardial infarction (STEMI) is an uncommon diagnosis in patients less than 40 years of age. Over the last two decades, there is an increase in the frequency of cardiovascular events among young adults. However, at present there is only limited clinical data on the clinical characteristics and outcomes of STEMI in young patients who were treated with primary percutaneous coronary intervention (pPCI). Plaque erosion is the underlying pathological mechanism leading to STEMI in the vast majority of young adults. Thrombi that complicate superficial erosion seem more platelet-rich than the fibrinous clots precipitated by plaque rupture. Mean platelet volume (MPV) is recognized as a marker of the platelet activation process and may be a better indicator of short-term prognosis than the inflammatory markers in young patients with STEMI. Therefore, we aimed to investigate clinical and angiographic characteristics, risk factors and the independent value of MPV on predicting short-term major adverse cardiovascular events (MACEs) in young adults with STEMI. Methods: A total of 349 patients aged 40 years or younger who underwent pPCI at our center between 2010–2015 with the diagnosis of STEMI were retrospectively analyzed. Results: The mean age of the patients was 36.4 ± 3.6 years and 90% of them were men. Smoking was by far the most frequent cardiovascular risk factor. MACEs were observed in 23 patients (6.6%), and according to the multivariate regression analysis, Killip IIIIV (OR 7.52, 95% CI 1.25–45.24, p = 0.03), lower admission SBP (OR 0.94, 95% CI 0.90–0.98, p <0.01) and increased MPV (OR 1.67, 95% CI 1.05–2.67, p = 0.03) were found to be independently correlated with MACE in the study population. Conclusion: Our results indicate that MPV is an independent predictor of MACEs at the short-term follow-up in young patients with STEMI undergoing pPCI. Accordingly, we suggested that MPV, a marker of platelet activation, could play a significant role in predicting clinical evolution in young patients with STEMI.

Is nucleate cell count and neutrophil to lymphocyte ratio related to patients with audiographically distinct sudden sensorineural hearing loss?

The aim of this study was to investigate the possible relationships between sudden sensorineural hearing loss (SSNHL) patients with distinct audiographic data and nucleate cell count and neutrophil to lymphocyte ratio (NLR).SSNHL patients differed in audiographic curves were included, 40 with low-frequency SSNHL (LF-SSNHL), 33 with high-frequency SSNHL (HF-SSNHL), 36 with all-frequency SSNHL (AF-SSNHL), 34 with total-deafness SSNHL (TD-SSNHL), and 31 age- and sex-matched healthy controls. Peripheral venous blood samples were collected and nucleate cell such as white blood cell (WBC), neutrophil and lymphocyte, and NLR were measured. Each group was divided into recovery and unrecovery subgroup according to hearing levels after 1-month therapy, and then compared the difference of the count of WBC, neutrophil and lymphocyte, and NLR between the 2 subgroups.The WBC count of the HF-SSNHL, AF-SSNHL, and TD-SSNHL group was significantly higher than that of the control group (P = .024, P = .003, P = .008, respectively), not for LF-SSNHL group (P = .248). WBC count between LF-SSNHL and AF-SSNHL group was significantly different (P = .045). The neutrophil count of the HF-SSNHL, AF-SSNHL, and TD-SSNHL group was significantly higher than that of the control group (P = .002, P = .000, P = .000, respectively), not for LF-SSNHL group (P = .069). Neutrophil count of LF-SSNHL was significantly lower than that of AF-SSNHL and TD-SSNHL groups (P = .014, P = .013). The lymphocyte count of AF-SSNHL and TD-SSNHL group was significantly lower than that of the control group (P = .027, P = .003), not for LF-SSNHL and HF-SSNHL group (P = .119, P = .054). NLR of HF-SSNHL, AF-SSNHL, and TD-SSNHL group was significantly higher than that of the control group (P = .001, P = .000, P = .000, respectively), not for LF-SSNHL group (P = .070). NLR of LF-SSNHL was significantly lower than that of AF-SSNHL and TD-SSNHL group (P = .041, P = .005). In HF-SSNHL patients, lymphocyte count of unrecovery subgroup was significantly lower, while NLR of the unrecovery subgroup were significantly higher than those of recovery subgroup (P = .017, P = .015).The count of WBC, neutrophil, lymphocyte, and NLR may be related to SSNHL, but they were unreliable at predicting SSNHL characterized by differences in audiometric curves. Higher NLR and lower lymphocyte count maybe used to evaluate prognosis of HF-SSNHL patients.

Differences in platelet-related parameters among patients with audiographically distinct sudden sensorineural hearing loss: A retrospective study

We explored possible relationships between sudden sensorineural hearing loss (SSNHL) in patients differing in terms of audiographic data and the levels of vascular markers in routine blood data.We included 37 patients with low-frequency SSNHL (LF-SSNHL), 28 with high-frequency SSNHL (HF-SSNHL), 32 with all-frequency SSNHL (AF-SSNHL), 32 with total-deafness SSNHL (TD-SSNHL), and 31 age- and sex-matched healthy controls. Peripheral venous blood samples were collected, and routine blood parameters including platelet and lymphocyte count, mean platelet volume (MPV), and platelet-to-lymphocyte ratio (PLR) were measured. Each group was divided into recovery subgroup and unrecovery subgroup in accordance with hearing level after 1 month therapy, then compared the difference of platelet and lymphocyte count, MPV, and PLR between the 2 subgroups.No significant difference was observed between platelet count of all SSNHL patients and control group (all P > .05). MPV of AF-SSNHL and TD-SSNHL, PLR of all SSNHL patients were significantly higher than those of control group (all P < .05), while lymphocyte count of all audiographically distinct SSNHL patients was significantly lower than that of control group (all P < .05). However, the difference of platelet count, lymphocyte count, MPV, and PLR among audiographically distinct SSNHL patients was not significant (all P > .05). In HF-SSNHL patients, lymphocyte count of unrecovery subgroup was significantly lower, while MPV and PLR of the unrecovery subgroup were significantly higher than those of recovery subgroup (all P < .05). In AF-SSNHL patients, MPV of the unrecovery group was significantly higher than that of recovery subgroup (P < .05).Lymphocyte count, MPV, and PLR may be relative to SSSNHL, but they could not be used to distinct SSNHL audiographically. Lower lymphocyte, higher MPV, and PLR may be indicative for the prognosis of HF-SSNHL patients; higher MPV may be related to bad treatment outcome of AF-SSNHL patients.

Prognostic value of mean platelet volume on tinnitus

OBJECTIVE

This study aimed to determine whether there was any relationship between tinnitus and mean platelet volume.

METHODS

This retrospective study was conducted between January 2013 and January 2014 in Ankara Atatürk Hospital and Ondokuz Mayıs University Hospital, Turkey, on a study group of 86 patients with tinnitus and a control group of 84 healthy subjects. Mean platelet volume was recorded and comparisons were made between the two groups.

RESULTS

Mean (± standard deviation) platelet volume was 7.67 ± 0.83 μm(3) in the study group and 7.28 ± 0.56 μm(3) in the control group. There was a statistically significant difference in mean platelet volume between the tinnitus patients and the healthy subjects (p < 0.05).

CONCLUSION

The clinical findings indicated that tinnitus patients had a higher mean platelet volume than the healthy control subjects; however, the pathophysiological mechanism remains unclear.

Mean platelet volume is associated with aortic intima-media thickness in patients without clinical manifestation of atherosclerotic cardiovascular disease

Objective:

Mean platelet volume (MPV) plays a pivotal role in the pathophysiology of atherosclerotic disease. Thoracic aortic intima-media thickness (IMT) was reported as an earlier marker of preclinical atherosclerosis than carotid IMT. However, the relationship between MPV and aortic IMT was not investigated. We aimed to assess the relationship between thoracic aortic IMT and MPV in patients undergoing transesophageal echocardiography (TEE) examination for different indications.

Methods:

We studied 190 patients (mean age 37.0±12.5 years) who underwent TEE for different indications. The patients who have known atherosclerotic disease were excluded from study. The patients were divided into 2 groups according to the median thoracic aortic IMT values (IMT_low group <13 mm and IMT_high group ≤13 mm). Platelet count and MPV were analyzed with an automated hematology analyzer. A multiple stepwise linear regression analysis was performed to identify the independent associations of thoracic aortic IMT.

Results:

The highest MPV values were observed in the IMT_high group compared with the IMT_low group (9.5±10 fL vs. 10.9±1.2 fL, p<0.001). Also, the IMT_high group had higher age, hs-CRP and uric acid levels (p<0.05 for all). Multiple linear regression analysis showed that aortic IMT was independently related with age (β=0.340, p<0.001), uric acid (β=0.111, p=0.041), hs-CRP (β=0.200, p<0.001), and MPV (β=0.482, p<0.001).

Conclusion:

MPV is independently related to the extent of subclinical thoracic aortic atherosclerosis. Increases in MPV may be a crucial biochemical marker for initial atherosclerosis.

Height, its components, and coagulability among older Chinese: the Guangzhou biobank cohort study

OBJECTIVES

The causal role of some cardiovascular risk factors, such as HDL cholesterol, has been increasingly challenged and attention is returning to all elements of Virchow's triad, i.e., hypercoagulability (including viscosity) as well as endothelial function and blood flow. We examined the life course origins of coagulability.

METHODS

We used multivariable linear regression to assess whether childhood influences, proxied by height and its components, were associated with hematocrit (Hct), hemoglobin (HGB), and other hematological parameters in 28,595 older Chinese adults (mean age = 61.8 years) from the Guangzhou Biobank Cohort Study.

RESULTS

Adjusted for age, sex, and recruitment phase, leg length was negatively associated with platelets (PLT) (-0.83 × 10(9) /l per centimeter (cm), 95% confidence interval (CI) -1.01 to -0.65). Sitting height and height were positively associated with Hct (0.05% per cm, 95% CI 0.04-0.07 for sitting height; 0.02% per cm, 95% CI 0.01-0.02 for height), HGB (0.21 g/l per cm, 95% CI 0.17-0.25; 0.07 g/l per cm, 95% CI 0.04-0.09) and negatively associated with PLT (-1.2 × 10(9) /l per cm, 95% CI -1.4 to -1.0; -0.83 × 10(9) /l per cm, 95% CI -0.95 to -0.70). Further adjustment for potential confounders did little to change the estimates.

CONCLUSIONS

For the first time we provide anthropometric evidence for the different roles of prepubertal and pubertal influences in relation to Hct and HGB. Whether factors that promote leg growth but reduce growth of sitting height may help to prevent cardiovascular events, via effects on hypercoagulability or viscosity, overall or in specific subgroups, remains to be determined.

Do platelet indices have a role in benign paroxysmal positional vertigo?

OBJECTIVES

Benign paroxysmal positional vertigo (BPPV) is a frequently encountered condition that can severely affect quality of life. Present study was undertaken to investigate whether the platelet (PLT) indices, including mean platelet volume (MPV), platelet distribution width (PDW), and platelet crit (PCT), could serve as diagnostic tools in patients with BPPV.

METHODS

Consecutive 45 BPPV patients and age- and sex-matched 40 control subjects were enrolled in this cross-sectional prospective study. Benign paroxysmal positional vertigo patients underwent a complete audio-vestibular test battery including Dix-Hallpike maneuver. Routine laboratory analyses were performed in both of the groups.

RESULTS

In BPPV patients, PLT, MPV, and PDW were found significantly higher than in controls (P < 0·05). Platelet and mean platelet volume were independently associated with BPPV (P  =  0·002 and P < 0·001, respectively). Platelet and platelet crit were significantly higher in patients with BPPV involving the left labyrinth than in those with the right affected side (P < 0·05). Mean platelet volume and platelet distribution width were to be significantly higher in the BPPV patients with recurrent vertigo attack than in those with first-ever attack (P < 0·001). A cutoff value of 8·75 for MPV and 16·65 for PDW parameters were obtained to identify the recurrence in BPPV patients in the receiving operating characteristic (ROC) analysis.

CONCLUSIONS

Elevated PLT indices were associated with BPPV requiring further efforts to better clarify this issue.

Mean platelet volume may predict early clinical outcome after coronary artery bypass grafting

Background

An elevated mean platelet volume is associated with increased platelet activation and thus may predict thrombotic events. The goal of this study was to investigate the association of the mean platelet volume and the major adverse events after coronary artery bypass surgery.

Methods

Baseline clinical details and preoperative hematologic parameters were obtained prospectively in 205 consecutive patients undergoing coronary artery bypass surgery. Postoperative mortality and major adverse events were recorded in the early postoperative period (median of 72 days, interquartile range 58.5-109 days).

Results

Combined adverse events occurred in 37 patients (18.0%) during the early follow-up. The preoperative mean platelet volume and hematocrit levels were found to be associated with postoperative adverse events (p<0.001 for both variables). In multivariate logistic regression models, the preoperative mean platelet volume and hematocrit levels were strong independent predictors of combined adverse events after surgery (respectively OR 1.89, p=0.037; OR 0.87, p=0.011). After receiver-operating-characteristics curve analysis, using a cut-point of 8.75 fL, the preoperative mean platelet volume level predicted adverse events with a sensitivity of 54% and specificity of 70%. In a further model with cut-off points, higher preoperative mean platelet volume levels remained a powerful independent predictor of postoperative myocardial infarction (OR 3.60, p=0.013) and major adverse cardiac events (OR 2.53, p=0.045).

Conclusions

An elevated preoperative mean platelet volume is associated with an adverse outcome after coronary artery bypass grafting. In conclusion, we can say that mean platelet volume is an important, simple, readily available, and cost effective tool and can be useful in predicting the postoperative adverse events in patients undergoing coronary artery bypass grafting.