Investigate The Clinical Significance Of Red Cell Distribution Width In Chronic Heart Failure

AimsTo analyze the retrospective data, we want to get the message of the releationship between RDW level and clinical indicators in chronic heart failure population. Discuss the mechanism why RDW as a powerful maker of prognosis in chronic heart failure. Provide a reference for clinical strategies.MethodsWe enrolled 178 consecutive cases admittde to the Second Affiliated of Chongqing University of Medical Sciences between Jan.1 2010 to Dec. 31 2010 who were diagnosed as chronic heart failure on the basis of Framingham criteria, then excluded the cases which according with the exclusion criterias. The general information,physical examination,blood biochemistry and auxiliary examination were collected. Enrolled cases were classified into 3 groups by baseline red cell distribution width levels :<13.1%(n=65), 13.1%-14.5%(n=61),>14.5%(n=52). ResultsThe patients with higher RDW levels had more extensive comorbidities including anemia and chronic atrial fibrillation. New York Heart Association(NYHA) functional classes were higher in patients with higher RDW levels(P<0.05); there were no significance differences in age, gender and prevalence of diabetes mellitus among the three groups(P>0.05). Physical examination: diastolic pressure, systolic pressure and moist rales among the three groups had no significance difference(P>0.05), but patients with higher RDW levels had a higher heart rate and more extensive lower extremity edema(P<0.05). Blood biochemistry: Patients with high RDW levels had lower Hb, MCV, eGFR , ALB, PAB levels but higer UA and BUN levels(P<0.05). but the difference of index such as erythrocytes, Hct, leucocyte, blood platelets, sodium, kalium, creatinine, hs-CRP among the thtee groups had no statistical significance(P>0.05). Auxiliary examination: LVEF decreased with RDW increased, the difference among the three groups had statistically significant(P<0.05), but there were no significance difference of cardiomegaly, pulmonary venous pleonaemia and LVEDD among the three groups(P>0.05). We select the variables which have significant difference when we do univariate analysis among the three groups as influencing factors of RDW level and do the Multivariate Logistic regression. The consequence shows that elevated RDW is correlated with NYHA functional class, LVEF, BUN, eGFR,Hb,and PAB. Conculsion1.NYHA functional class increased but LVEF decreased with increased RDW in chronic heart failure patients. 2.The mechanism why RDW affect the prognostic may include malnutrition, blood abnormalities, body systemic inflammation and renal insufficiency. 3.Multivariate Logistic regression showed NYHA functional class, LVEF, BUN, eGFR were risk factors of increaded RDW but Hb, PAB as protective factors.4.RDW can assess the pathogenetic of patient with chronic heart failure, provide a reference for clinical strategies.