Hubungan antara Nilai Rasio Neutrofil – Limfosit dengan Derajat Keparahan Stenosis Mitral Akibat Penyakit Jantung Rematik pada Pasien Rawat Jalan di RSUP H. Adam Malik Medan

Abstract

Introduction: Mitral stenosis (MS) is a form of valvular disease characterized by a narrowing of the opening of the mitral valve. Evaluation of the severity of mitral stenosis is very important in its management, where the gold standard is the echocardiography. One simple examination that may be associated with the severity of mitral stenosis is the ratio of Neutrophils to Lymphocytes (NLR) which is associated with the degree of inflammation as the basic pathophysiology in rheumatic heart disease. This study aims to assess the relationship between NLR values and the severity of mitral stenosis due to rheumatic heart disease. Methods: This study was a cross-sectional study conducted at H. Adam Malik Hospital Medan held from January 2023 until the number of samples is met. The patients used in this study were patients that diagnosed with mitral stenosis by echocardiography based on the American Society of Echocardiography (ASE) criteria. Echocardiography parameters such as MVA, MV mean PG, and blood laboratory parameters such as NLR values were obtained in which the association for relevance were evaluated using statistical measurement. P value of < 0.05 is considered significant. Results: There was a significant difference between the mean value and the minimum maximum value of NLR in mitral stenosis of mild severity, (1.93; 0.82 – 10.64) and severe (3.56; 1.81 – 13.08); (P = 0.0001; Mann-Whitney test). The NLR value can be used to predict the severity of severe mitral stenosis, where the NLR threshold value of 2.91 has a sensitivity of 82% and a specificity of 81.8% (P = 0.0001; AUC 0.856; 95% CI 0.772 – 0.940). Conclusion: The NLR value is associated with the severity of mitral stenosis and has a good predictor power for the severity of mitral stenosis due to rheumatic heart disease.