Title:Neutrophil-Lymphocyte Ratio and Red Blood Cell Distribution Width in
Patients with Atrial Fibrillation and Rheumatic Valve Disease
Volume: 21
Issue: 6
Author(s): Rose Mary Ferreira Lisboa da Silva*Lucas Espindula Borges
Affiliation:
- Department of Internal Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas
Gerais, Brazil
- Postgraduate Program in Sciences Applied to Adult Health, Federal University of Minas Gerais, Belo
Horizonte, Minas Gerais, Brazil
Keywords:
Atrial fibrillation, rheumatic heart disease, red cell distribution width, neutrophil-lymphocyte ratio, inflammation, biomarker.
Abstract: The lifetime risk of developing atrial fibrillation (AF) is 1 in 3 adults, resulting in a prevalence
of 2-4%. Rheumatic heart disease (RHD) is a frequent aetiology of valvular heart disease in lowand
middle-income countries. Between 21% and 80% of patients with mitral valve disease, especially
with stenosis, may have AF. Both these conditions, AF and RHD, present a state of persistent inflammation.
In turn, inflammation is a frequent cause of anisocytosis, which can be evidenced through the parameter
RDW (red bold cell distribution width). Factors associated with increased RDW are also known
as risk factors associated with a higher incidence of AF. RDW may have an independent role in the
pathogenesis of AF and the increased propensity of both thromboembolic and bleeding events. Another
marker involved in the incidence of AF is the neutrophil-lymphocyte ratio. This is also a marker of oxidative
stress and inflammation and is associated with a higher rate of AF recurrence. This review will
evaluate these biomarkers and their association with cardiovascular events in patients with AF and
RHD. The hypotheses and current debates about the relationship of biomarkers with the severity of
chronic valve dysfunction, with acute rheumatic carditis in the paediatric population, and with the presence
of thrombus in the left atrium will be discussed.
