Circulating CD19 B cell count, myocardial injury and clinical outcomes in patients with heart failure

IF 3.7 2区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

ESC Heart Failure Pub Date : 2025-07-22 DOI:10.1002/ehf2.15382

Yuta Kobayashi, Yoichiro Otaki, Tetsu Watanabe, Ryuhei Yamaguchi, Hiroe Ono, Shingo Tachibana, Junya Sato, Naoaki Hashimoto, Masahiro Wanezaki, Daisuke Kutsuzawa, Takanori Arimoto, Masafumi Watanabe

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Abstract

Aims

Heart failure (HF) is a steadily increasing health problem associated with a high mortality rate. Lymphocytopenia is common and reportedly associated with poor clinical outcomes in patients with HF. Alterations in circulating lymphocyte subsets have not been examined. The current study focused on the CD19 cell count, B cells and examined whether alteration of lymphocyte subsets can predict clinical outcomes in patients with HF.

Methods

Three hundred ninety-five consecutive patients with HF were enrolled (mean age 73, 59.6% men). Circulating lymphocyte subset counts (CD3 cells: T cells; CD19 cells: B cells; and CD56 cells: NK cells) were evaluated. All patients were prospectively followed for a median period of 374 days. The primary and secondary endpoints were all-cause mortality and HF-related events, respectively.

Results

Simple linear analysis indicated that circulating CD19 B cell counts negatively correlated with heart-type fatty acid-binding protein levels (r = −0.3669; P < 0.0001). The C-index of the CD19 B cell count for all-cause mortality was the highest among the lymphocyte subset counts (C-index 0.73085 vs. 0.69063, 0.65312, 0.60117). Multivariate Cox proportional hazard regression analysis demonstrated that the CD19 B cell count was an independent predictor of all-cause mortality and HF-related events after adjusting for confounding risk factors [hazard ratio (HR) 0.57; confidence interval (CI) 0.45–0.71; P < 0.0001 for all-cause mortality; HR 0.79; CI 0.64–0.98; P = 0.0293 for HF-related events], but not for other subset counts. Adding the CD19 B cell count to the basic risk factors significantly improved the C-index for all-cause mortality, with a significant net reclassification index and integrated discrimination improvement (C-index 0.8000 vs. 0.7609; P = 0.0256).

Conclusions

Circulating CD19 B cell counts correlated with myocardial injury and could be a feasible marker for clinical outcomes in patients with HF.

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心衰患者循环CD19 B细胞计数、心肌损伤和临床结局

目的：心力衰竭（HF）是一个稳定增长的健康问题，与高死亡率相关。淋巴细胞减少症是常见的，据报道与心衰患者的不良临床结果有关。循环淋巴细胞亚群的改变尚未被研究。目前的研究重点是CD19细胞计数、B细胞，并检查淋巴细胞亚群的改变是否可以预测HF患者的临床结局。方法：连续入组395例心衰患者（平均年龄73岁，男性59.6%）。循环淋巴细胞亚群计数(CD3细胞：T细胞；CD19细胞：B细胞；CD56细胞：NK细胞)。所有患者的随访时间中位数为374天。主要终点和次要终点分别是全因死亡率和hf相关事件。结果：简单线性分析显示，循环CD19 B细胞计数与心脏型脂肪酸结合蛋白水平呈负相关(r = -0.3669；结论：循环CD19 B细胞计数与心肌损伤相关，可能是心衰患者临床结局的可行标志。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ESC Heart Failure Medicine-Cardiology and Cardiovascular Medicine

CiteScore

7.00

自引率

7.90%

发文量

461

审稿时长

12 weeks

期刊介绍： ESC Heart Failure is the open access journal of the Heart Failure Association of the European Society of Cardiology dedicated to the advancement of knowledge in the field of heart failure. The journal aims to improve the understanding, prevention, investigation and treatment of heart failure. Molecular and cellular biology, pathology, physiology, electrophysiology, pharmacology, as well as the clinical, social and population sciences all form part of the discipline that is heart failure. Accordingly, submission of manuscripts on basic, translational, clinical and population sciences is invited. Original contributions on nursing, care of the elderly, primary care, health economics and other specialist fields related to heart failure are also welcome, as are case reports that highlight interesting aspects of heart failure care and treatment.