Association between monocyte to high-density lipoprotein cholesterol ratio and bicuspid\raortic valve degeneration

Abstract

Background/aim: From a pathophysiological point of view, inflammation is thought to be more dominant in bicuspid aortic valve\r(BAV) stenosis than tricuspid aortic valve (TAV) stenosis. Our study aimed to determine the association between monocyte to highdensity lipoprotein cholesterol (HDL-C) ratio (MHR), a new inflammatory marker, and the speed of progression of stenosis and\rpathophysiology of BAV stenosis.\rMaterials and methods: A total of 210 severe aortic stenosis patients (70 consecutive BAV patients, 140 matched TAV patients) were\rretrospectively enrolled in the study. Clinical and echocardiographic data and laboratory results related to our research were collected\rretrospectively from the patients’ records. MHR was measured as the ratio of the absolute monocyte count to the HDL-C value.\rResults: Seventy BAV (mean age: 72.0 ± 9.1 years, 42.9% female) and 140 TAV patients (mean age: 77.9 ± 8.3 years, 51.4% female)\rwith severe aortic stenosis were enrolled in this study. There was no difference between the two groups in terms of another baseline\rdemographic or clinic findings except age (P < 0.001). Monocyte count, hemoglobin level, mean platelet volume was significantly\rhigher, and HDL-C level was significantly lower in the BAV group, while other lipid and CBC parameters were found to be similar. In\rthe multivariate analysis, MHR (P = 0.005, 95% CI: 0.90–0.98) and, as expected, age (P = 0.001, 95% CI: 1.02–1.11) were found to be\rsignificant as the independent predictor of BAV, after adjusting for other risk factors.\rConclusion: Our study showed a significant correlation between increased MHR and BAV. MHR was determined as a significant\rindependent predictor for the speed of progression and diagnosis of severe BAV stenosis in multivariate analysis.