Correlation Analysis Between The Red Blood Cell Distribution Width And Atrial Fibrillation In Patients With Chronic Heart Failure

Objective:to analyze the relationship between the baseline red blood cell distribution width and the occurrence of atrial fibrillation in patients with chronic heart failure,and compare the difference of red blood cell distribution width in patients with sinus rhythm and atrial fibrillation in chronic heart failure.Methods: a total of 255 patients with chronic heart failure who were hospitalized in the heart center of the first hospital of Lanzhou University from December 2016 to December 2019 were divided into sinus rhythm group(n = 98)and atrial fibrillation group(n = 157).The baseline clinical indexes of the two groups were collected:Complete blood count(CBC): hemoglobin(HGB),red blood cell distribution width(RDW),platelet distribution width(PDW),neutrophil absolute value(N),lymphocyte absolute value(L),and the ratio of neutrophil absolute value to lymphocyte absolute value(NRL)was calculated.Biochemical indexes: cholesterol(TC),triglyceride(TG)High density lipoprotein(HDL-C),low density lipoprotein(LDL-C),NT-proBNP and LVEF are the indexes of cardiac function.First of all,we compared the baseline data and clinical indicators of the two groups,and analyzed the influencing factors of AF in HF patients by binary logistic regression.Second,we compared the correlation between RDW and known cardiac function indexes LVEF and NT proBNP.Finally,we analyzed the predictive value of RDW for AF in chronic HF patients by drawing the ROC curve Value.Results:(1)there were no significant difference in sex,age and NYHA grade between the two groups(P>0.05);(2)there were also no significant difference in HGB,PDW,TG and NRL between the two groups(P>0.05);(3)RDW and NT proBNP levels in the atrial fibrillation group were higher than those in the sinus rhythm group,while LVEF 、TC、HDL-C、LDL-C were lower than that in the sinusrhythm group(P < 0.05);(4)RDW was positively correlated with NT-proBNP(P =0.003),negatively correlated with LVEF(P = 0.005);(5)binary logistic regression analysis showed that RDW was an independent factor to predict the occurrence of atrial fibrillation in patients with chronic heart failure;(6)ROC curve analysis showed that the area under the curve of RDW predicting the occurrence of atrial fibrillation in patients with chronic heart failure was 0.701(P < 0.001),the 95% confidence interval was 0.629-0.773,the optimal cut-off value calculated according to the Jordan index was 13.75%,.This value corresponds to a diagnostic sensitivity of 85% and a specificity of 53%,respectively.Conclusion: the baseline RDW was significantly increased in HF patients with atrial fibrillation,which was positively correlated with RDW and NT-proBNP,and negatively correlated with LVEF.In the future clinical work,more attention should be paid to HF patients with higher RDW level.