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Among 2085 asymptomatic subjects (age: 51.0±10.7 years, 41.3% female) with data available on common carotid artery diameter (CCAD) and circulating total white blood cell (WBC) counts, higher circulating leukocytes positively correlated with higher high sensitivity C-reactive protein (hs-CRP).Higher WBC/segmented cells and monocyte counts were independently associated with greater relative wall thicknesses and larger CCADs,which in generalweremore pronounced in men and obese subjects (body mass index ≥ 25kg/m 2 ) (all P interaction : &lt; 0.05). Using multivariate adjusting models, only the monocyte count independently predicted theleft ventricularmass index (LVMi) (ß-Coef: 0.06, p = 0.01). Higher circulating WBC, segmented,and monocyte counts and a greater CCAD were all independently associated with a higher risk of heart failure (HF)/all-cause death during a median of 12.1 years of follow-up in fully adjusted models, with individuals manifesting both higher CCADs and monocyte countsincurring the highest risk of HF/death (adjusted hazard ratio: 2.81, 95% CI: 1.57. -5.03, p &lt; 0.001; P interaction , 0.035; lower CCAD/lower monocyte as reference). We conclude that a higher monocyte count is associated with cardiac remodeling and carotid artery dilation.Both an elevated monocyte count and a larger CCAD may indicate a specific phenotype that confers the highest risk of HF, which likely signifies the role of circulating monocytes in the pathophysiology of heart failure with preserved ejection fraction (HFpEF).

Circulating Monocyte Count as a Surrogate Marker for Ventricular-Arterial Remodeling and Incident Heart Failure with Preserved Ejection Fraction