Red blood cell distribution width and its relation to cardiac function and biomarkers in a prospective hospital cohort referred for echocardiography

• Published in: European journal of internal medicine Vol. 23; no. 7; pp. 604 - 609
• Main Authors: Holmström, Alexandra, Sigurjonsdottir, Runa, Hammarsten, Ola, Gustafsson, Dan, Petzold, Max, Fu, Michael L.X
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.10.2012
• Subjects: acute heart-failure; Aged; Aged, 80 and over; Biomarkers; Clinical Medicine; Cohort Studies; diagnosis; Echocardiography; Erythrocyte Indices; Female; Heart Failure - blood; Heart Failure - diagnosis; Heart failure with normal ejection fraction; Heart Failure, Systolic - blood; Heart Failure, Systolic - diagnosis; Humans; Internal Medicine; Klinisk medicin; Linear Models; Male; Middle Aged; mortality; Natriuretic Peptide, Brain - blood; NT-proBNP; Peptide Fragments - blood; Prognosis; prognostic marker; Prospective Studies; RDW; Stroke Volume; Systolic heart failure; ventricular ejection fraction; NT-proBNP; RDW; Heart failure with normal ejection fraction; Systolic heart failure
• ISSN: 0953-6205; 1879-0828
• DOI: 10.1016/j.ejim.2012.05.005

Abstract Background Red blood cell distribution width (RDW), a measure of anisocytosis, is a prognostic biomarker for heart failure (HF). However it is still unclear how RDW is associated with heart function and established cardiac biomarkers. Methods and results In a prospective hospital cohort of 296 patients referred for echocardiography because of suspected HF, blood sampling and clinical examination were performed within 24 h after echocardiography. The patients were divided into four HF groups, including one group where the HF diagnosis was uncertain (gray zone). In the patients the mean age was 70 ± 11 years, 44% with systolic HF (SHF), 18% with heart failure with normal ejection fraction (HFNEF), 17% with gray zone and 21% without HF (non-HF). RDW was higher among patients with SHF and HFNEF, compared with gray zone and non-HF patients. The distribution of different variables over the RDW quartiles showed an inverse correlation between RDW levels and LVEF and a positive correlation between RDW and NT-proBNP levels. Further analysis with stepwise multiple linear regression demonstrated that NT-proBNP levels, but not LVEF, were independently correlated with RDW. Conclusion In patients referred for echocardiography because of suspected HF, RDW levels were higher in patients with SHF and HFNEF. Moreover, NT-proBNP levels were independently linked with elevated RDW.