The association between circulating B cell count and clinical outcomes in patients with heart failure

Abstract Background Despite advances in treatments, heart failure (HF) is still an growing health problem associated with a high mortality rate. In recent years, researchers have increasingly focused on the association between HF and the immune system. However, there have been only a few reports concerning the association between B cells and heart failure. The aim of the present study was to identify alterations in lymphocyte subset counts and examine whether lymphocyte subset counts are associated with clinical outcomes in patients with HF. Methods and Results We evaluated lymphocyte subset count, including CD3+ T cells, CD19+ B cells and CD56+ natural killer cells in consecutive 395 patients with HF. All patients were divided into three groups according to CD19+ B cell counts tertiles. First tertile group showed higher inflammation and higher prevalence of malnutrition compared to other groups. There were 79 all-cause deaths and 119 HF-related events during the median follow-up period of 374 days. We found that each lymphocyte subsets decreased with advancing New York Heart Association functional class. The receiver operating characteristics curve analysis demonstrated that the area under the curve of CD19+ B cell count for all-cause mortality was the greatest among lymphocyte subset counts. Kaplan-Meier analysis showed that patients with lowest tertile group had the highest rates of all-cause deaths and HF-related events than in other groups. Multivariate Cox proportional hazard regression analysis demonstrated that CD19+ B cell count was significantly associated with all-cause mortality and HF-related events after adjustment for confounding risk factors. Conclusion We for the first time demonstrated that the CD19+ B cell count was significantly associated with severity and clinical outcomes of HF.Kaplan-Meiyer curveforest plot