BACKGROUND AND OBJECTIVES: Coronary angiography (CAG) is generally needed in the setting of systolic heart failure (HF) with an unidentified etiology as a part of diagnostic strategy. On the other hand, the clinical value of this invasive strategy is largely unknown. Platelet-lymphocyte ratio (PLR) has recently emerged as a novel inflammatory index that may serve as an important predictor of inflammatory state and overall mortality. The present study aimed to search the predictive value of PLR in determining the extent of coronary atherosclerosis in asymptomatic low ejection fraction (EF) patients. SUBJECTS AND METHODS: 156 asymptomatic heart failure (HF) subjects (without angina or HF symptoms, mean age: 58 years; to male: 71.2%) were enrolled, and thereafter a CAG was performed. Gensini Score was used to determine the severity of coronary artery disease (CAD) on CAG. According to this scoring system, the overall study group was categorized into three distinct subgroups: control group with the score 0, mild atherosclerosis group with the score 0 to 20 and severe atherosclerosis group with the score of >20. Thereafter, a comparison was made among groups with regard to mean values of PLR. RESULTS: The severe atherosclerosis group had a substantially higher level of mean PLR in comparison to other groups (p<0.001). Pre-CAG PLR levels as well as a variety of clinical variables including age, low density lipoprotein (LDL)-cholesterol demonstrated an independent correlation with Gensini score through a multivariate analysis. CONCLUSION: These findings suggest the potential association of high PLR levels with severe atherosclerosis in the setting of asymptomatic systolic HF. A simple measurement of PLR helps to identify the severity of coronary atherosclerosis prior to conducting coronary angiography.
Asymptomatic Diseases ; Atherosclerosis ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Hand ; Heart Failure ; Heart Failure, Systolic ; Humans ; Lipoproteins ; Male ; Mortality ; Multivariate Analysis

Background and Objectives: The HUC-HEART Trial (ClinicalTrials.gov Identifier: NCT02323477) was a controlled, prospective, phase I/II, multicenter, single-blind, three-arm randomized study of intramyocardial delivery of human umbilical cord-derived mesenchymal stromal cells (HUC-MSCs) combined with coronary artery bypass-grafting (CABG) in patients with chronic ischemic cardiomyopathy (CIC). The trial aimed to assess (i) the safety and the efficacy of cell transplantation during one-year follow-up, (ii) to compare the efficacy of HUC-MSCs with autologous bone-marrow- derived mononuclear cells (BM-MNCs) in the same clinical settings. Methods: and Results: Fifty-four patients who were randomized to receive HUC-MSCs (23×106) (n=26) or BM-MNCs (70×107) (n=12) in combination with CABG surgery. The control patients (n=16) received no cells/vehicles but CABG intervention. All patients were screened at baseline and 1, 3, 6, 12 months after transplantation. Forty-six (85%) patients completed 12 months follow-up. No short/mid-term adverse events were encountered. Decline in NT-proBNP (baseline∼ 6 months) in both cell-treated groups; an increase in left ventricular ejection fraction (LVEF) (5.4%) and stroke volume (19.7%) were noted (baseline∼6 or 12 months) only in the HUC-MSC group. Decreases were also detected in necrotic myocardium as 2.3% in the control, 4.5% in BM-MNC, and 7.7% in the HUC-MSC groups. The 6-min walking test revealed an increase in the control (14.4%) and HUC-MSC (23.1%) groups. Conclusions Significant findings directly related to the intramyocardial delivery of HUC-MSCs justified their efficacy in CIC. Stricter patient selection criteria with precisely aligned cell dose and delivery intervals, rigorous follow-up by detailed diagnostic approaches would further help to clarify the responsiveness to the therapy.

Objective To determine the antileishmanial vaccine effectiveness of lipophosphoglycan (LPG) and polyacrylic acids (PAA) conjugates on in vivo mice models. Methods LPG molecule was isolated and purified from large-scale Leishmania donovani parasite culture. Protection efficacies of LPG alone, in combination with Freund's adjuvant, in a physical mixture and in conjugate (consisting of various LPG concentrations) with PAA, were comparatively determined by various techniques, such as cultivation with the micro-culture method, assessment of in vitro infection rates of peritoneal macrophages, determination of parasite load in liver with Leishman-Donovan Units, and detection of cytokine responses. Results Obtained results demonstrated that the highest vaccine-mediated immune protection was provided by LPG-PAA conjugate due to all parameters investigated. According to the Leishman-Donovan Units results, the sharpest decline in parasite load was seen with a ratio of 81.17% when 35 μg LPG containing conjugate was applied. This value was 44.93% for the control group immunized only with LPG. Moreover, decreases in parasite load were 53.37%, 55.2% and 65.8% for the groups immunized with 10 μg LPG containing LPG-PAA conjugate, a physical mixture of the LPG–PAA, and a mixture of LPG + Freund's adjuvant, respectively. Furthermore, cytokine results supported that Th1 mediated protection occurred when mice were immunized with LPG-PAA conjugate. Conclusions It has been demonstrated in this study that conjugate of LPG and PAA has an antileishmanial vaccine effect against visceral leishmaniasis. In this respect, the present study may lead to new vaccine approaches based on high immunogenic LPG molecule and adjuvant polymers in fighting against Leishmania infection.