Diagnostic values of neutrophil-to-lymphocyte ratio and Tei index for congenital heart disease-associated pulmonary arterial hypertension in children

Abstract

About 10% of children with congenital heart disease (CHD) have pulmonary arterial hypertension (PAH). In this study, we explored the diagnostic values of neutrophil-to-lymphocyte ratio (NLR) and Tei index for CHD-PAH in children. In order to complete the study, two hundred CHD children treated in our hospital from January 2015 to January 2017 were enrolled and divided into postoperative-PAH group (n=29) and no postoperative-PAH group (n=171) according to follow-up results. The peripheral blood was drawn after surgery, neutrophils and lymphocytes were measured by routine blood test, and NLR was calculated. Ventricular Tei index was determined by pulse Doppler, and the other basic data were compared. Factors affecting postoperative PAH were explored by multivariate analysis. The correlations of NLR and Tei index with N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cardiac output/pulmonary blood flow (CO/Qp), were analyzed. The structural equation model of PAH was constructed. According to receiver operating characteristic (ROC) curves, the optimal cutoff values of NLR and Tei index for evaluating postoperative PAH were investigated. It has been found that NLR and Tei index are closely related to CHD-PAH in children, which indirectly reflect the severity and have high diagnostic values.