Relationship between red blood cell distribution width and prognosis of chronic heart failure: an observational study

doi:10.3877/cma.j.issn.1674-0785.2021.01.008

Abstract

Abstract:

Objective

To observe the distribution of red blood cell distribution width (RDW) in patients with heart failure, to explore the change of the RDW in different clinical situations, and to analyze the association between RDW and prognostic consequences in patients with heart failure.

Methods

Three hundred and thirty patients who were admitted to Department of Cardiology, Shougang Shuigang General Hospital from January 2013 to March 2018 were analyzed, including 213 with heart failure [New York Heart Association class Ⅱ/Ⅲ/Ⅳ of 100/88/25 cases] and 117 with normal heart function. The differences in RDW, brain natriuretic polypeptide (BNP), and left ventricular ejection fraction (LVEF) among patients with different heart function classifications and different times of hospitalization were analyzed. The mortality rates were compared between the patients with normal RDW (174 cases) and those with higher RDW (39 cases). The associations between BNP, LVEF, and RDW were assessed by correlation analysis.

Results

RDW and BNP were significantly higher and LVEF was significantly lower in patients with heart failure than in those with normal heart function (P＜0.05). With the deterioration of NYHA, RDW and BNP became higher, and LVEF became lower. Compared with patients who had 1-2 times of hospitalization, patients with ＞2 times of hospitalization had significantly higher RDW [(47.72±4.92)% vs (46.23±3.92)%] and BNP [(4179.10±3742.16) pg/ml vs (3229.69±3231.47) pg/ml, P＜0.05], and lower LVEF [(49.40±10.85)% vs (53.44±11.57)%, P＜0.05]. Among the 213 patients with heart failure, the mortality rate was significantly higher in patients with higher RDW (12.82%) than in those with normal RDW (2.87%,P＜0.05). The correlation analysis showed that the RDW and BNP were positively correlated (r=0.542, P＜0.01), while the RDW and LVEF were negatively correlated (r=-0.536, P＜0.01).

Conclusion

With the deterioration of the heart function and more hospitalization times, RDW shows a trend of gradual increase. With the increase of RDW, the mortality rate significantly increases. RDW is correlated with BNP and LVEF values. Therefore, RDW can be may be used as an indicator to assess the severity of cardiac function and patient prognosis.

Key words: Chronic heart failure, Red blood cell distribution width, Prognosis

Min Zhang, Zuoying Wang, Haiying Wu, Rui Liu, Lala Li, Guangping Chen, Lian Zeng, Dongying Zhao, Wei Liu. Relationship between red blood cell distribution width and prognosis of chronic heart failure: an observational study[J]. Chinese Journal of Clinicians(Electronic Edition), 2021, 15(01): 43-46.

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References 15

1	Felker GM, Allen LA, Pocock SJ, et al. Red cell distribution width as a novel prognostic marker in heart failure:data from the CHARM Program and the Duke databank [J]. J Am Coll Cardiol, 2007, 50: 40-47.
2	Tonelli M, Sacks F, Arnold M, et al. Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease [J]. Circulation, 2008, 117(2): 163-168.
3	盛春梅, 马礼坤. 红细胞体积分布宽度与冠心病的关系研究 [J]. 安徽医学, 2014, 35(12): 1667-1669.
4	王国峰, 王晓丽. 红细胞体积分布宽度与冠心病关系的研究近况 [J]. 医学与哲学, 2014, 35(24): 56-58.
5	秦琴, 汪怀周, 胡志德, 等. 红细胞体积分布宽度异质性参数预测急性心肌梗死患者近期预后的价值 [J]. 临床检验杂志, 2012, 30(7): 515-517.
6	Torre-Amione G, Anker SD, Bourge RC, et al. Results of a nonspecific immunomodulation therapy in chronic heart failure (ACCLAIM trial): a placebo-controlled randomised trial [J]. Lancet, 2008, 371(9608): 228-236.
7	Pierce CN, Larson DF. Inflammatory cytokine inhibition of erythropoiesis in patients implanted with a mechanical circulatory assist device [J]. Perfusion, 2005, 20(2): 83-90.
8	Weiss G, Goodnough LT. Anemia of chronic disease [J]. N Engl J Med, 2005, 352(10): 1011-1023.
9	Cotter G, Felker GM, Adams KF, et al. The pathophysiology of acute heart failure-is it all about fluid accumulation? [J]. Am Heart J, 2008, 155(1): 9-18.
10	Westenbrink BD, Visser FW, Voors AA, et al. Anaemia in chronic heart failure is not only related to impaired renal perfusion and blunted erythropoietin production but to fluid retention as well [J]. Eur Heart J, 2007, 28(2): 166-171.
11	邓新桃, 石桂良, 王如兴, 等. Ｂ型利钠肽水平对慢性心力衰竭患者预后的影响 [J]. 中华心血管病杂志, 2012, 40(6): 462.
12	冷文修, 何昆仑, 范利, 等. BNP和NT-proBNP在鉴别舒张性心力衰竭中的应用研究 [J]. 中华检验医学杂志, 2010, 3(4): 328.
13	葛咏梅, 张立江. 血浆BNP检测在慢性心衰诊断及治疗中的应用 [J]. 中国实验诊断学, 2009, 13(11): 1572.
14	Jin M, Wei S, Gao R, et al. Predictors of long-term mortality in heart with acute heart failures [J]. Int heart J, 2017, 58(3): 409-415.
15	Pocock SJ, Ariti CA, McMurray JJ, et al. Predicting survival in heart failure: a risk score based on 39,372 patients from 30 studies [J]. Eur Heart J, 2013, 34(19): 1404-1413.

组别	例数	RDW（%）	BNP（pg/ml）	LVEF（%）
正常组	117	44.32±3.35	977.47±1357.54	59.40±5.95
心功能Ⅱ级	100	45.52±3.64^a	2650.04±3423.57^a	54.30±9.97^a
心功能Ⅲ级	88	46.96±3.76^a	4148.75±3447.68^a	50.32±12.90^a
心功能Ⅳ级	25	50.08±5.27^a	5465.60±3505.36^a	45.36±11.83^a
F值		20.142	29.065	21.973
P值		0.000	0.000	0.000

组别	例数	RDW（%）	BNP（pg/ml）	LVEF（%）
正常组	117	44.32±3.35	977.47±1357.54	59.40±5.95
心功能Ⅱ级	100	45.52±3.64^a	2650.04±3423.57^a	54.30±9.97^a
心功能Ⅲ级	88	46.96±3.76^a	4148.75±3447.68^a	50.32±12.90^a
心功能Ⅳ级	25	50.08±5.27^a	5465.60±3505.36^a	45.36±11.83^a
F值		20.142	29.065	21.973
P值		0.000	0.000	0.000

住院次数	例数	RDW（%）	BNP（pg/ml）	LVEF（%）
1~2次	135	46.23±3.92	3229.69±3231.47	53.44±11.57
＞2次	78	47.72±4.92	4179.10±3742.16	49.40±10.85
t值		-2.068	-2.294	-2.415
P值		0.039	0.022	0.016

住院次数	例数	RDW（%）	BNP（pg/ml）	LVEF（%）
1~2次	135	46.23±3.92	3229.69±3231.47	53.44±11.57
＞2次	78	47.72±4.92	4179.10±3742.16	49.40±10.85
t值		-2.068	-2.294	-2.415
P值		0.039	0.022	0.016

RDW值	例数	死亡情况[例（%）]	BNP（pg/ml）	LVEF（%）
增高（＞50%）	39	5（12.82）	4939.52±4024.41	47.26±12.60
正常（37%~50%）	174	5（2.87）	3272.05±3241.81	52.63±11.44
统计值		χ²=4.997	t=-2.593	t=-2.498
P值		0.025	0.010	0.012

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