Correlation Of Red Blood Cell Distribution Width With Cardiac Structure And Function In Patients With Heart Failure With Preserved Ejection Fraction

Objects:To investigate the relationship between red blood cell distribution width and cardiac structure and function in patients with HFpEF,and to analyze the possible influencing factors.Methods:A total of 396 newly diagnosed patients with HFpEF,and 109 patients in the healthy control group matched with the age and sex in the same period were selected to investigate their clinical characteristics and the correlation between red blood cell distribution width(RDW)and heart structure and function.Results:1)Relationship between RDW and right ventricular structure:HFpEF set of pulmonary artery systolic pressure(PASP),end systolic right ventricular free wall thickness(RV-FWs),the right ventricular base diameter(RV-D1),the right ventricular central Canon and long axis diameter(RV-D2、RV-D3),the right ventricular outflow tract(RVO-T1、RVO-T2)、the right atrial minor dimension and the long axis of the right atrial minor dimension(RA-D1、RA-D2)and RAA(right atrium area)are higher than the control group(P<0.05),and are positively correlated with RDW(r>0,P<0.05).In the control group,only RDW-SD was negatively correlated with RV-D2(R<0,P<0.05).Multiple linear regression analysis showed that RDW was independently correlated with right ventricular PASPand RVO-T1(β>0,P<0.05).2)Relationship between RDW and left ventricular structure:End-diastolic diameter and end systolic left indoor HFpEF group(LVIDd,LVIDs),end-diastolic and end systolic ventricular septal thickness(IVISTd,IVISTs),PTWd(end-diastolic),left ventricular posterior wall thickness,PTWs(end systolic left ventricular posterior wall thickness),RWT(relative room wall thickness),left ventricular mass and quality index(LVM-AL,LVMi-AL),left ventricular end-diastolic volume and volume index(LV-EDV,LV-EDVi),LV-ESV(left ventricular end-diastolic volume index),left atrium diameter and index(LAD,LADi),left atrial volume and volume index(LAV,LAVi)were higher than those in the control group(P<0.05);RDW was positively correlated with LVIDS,LAD,LADi,LAV and LAVi(r>0,P<0.05).Multiple linear regression analysis showed that RDW was independently correlated with LVEDi and LADI(β>0,P<0.05).3)the relationship between RDW and left heart function:HFpEF group LVEF(left ventricular ejection fraction),E(mitral valve mouth early diastolic blood flow velocity(peak E)),A(mitral valve opening late diastolic blood flow velocity(peak)A),E/A,D,IVRT(isovolumetric relaxation time),E/E,_L(E peak and the ratio of early diastolic mitral valve ring wall maximum speed),E/E,s(E peak early diastolic mitral valve ring and interventricular septum of the ratio of maximum speed),E/E,(E/E,_Lwith E/E,s average)and E/FPV higher than the control group(P<0.05);FS(short axis fraction),E,_L(the maximum velocity of the lateral wall of the mitral annulus in early diastolic period),E,_S(the maximum velocity of the interventricular septum of the mitral annulus in early diastolic period)were lower than those of the control group(P<0.05).RDW was positively correlated with E/A,E,_L(r>0,P<0.05).RDW was negatively correlated with FS,LVEF,EDT and IVRT(r<0,P<0.05).Multiple linear regression showed that RDW was independently correlated with E/E,_L(β>0,P<0.05)and EDT(β<0,P<0.05).Conclusion:In HFpEF patients,heart size and thickness were significantly higher than those in the control group.RDW was positively correlated with the size and thickness of the right heart in patients with HFPEF,and was independently correlated with pulmonary systolic pressure and the inner diameter of the right ventricular outflow tract.RDW was positively correlated with the size of left atrium and left ventricle,left ventricular mass index and some indexes of left ventricular diastolic function.RDW was negatively correlated with left ventricular systolic function.And left ventricular volume prime number,left atrial diameter index,E/E,_L,E peak deceleration time were independently correlated.It was independently associated with NT-pro BNP.In summary,in patients with HFPEF,the higher of the RDW,the larger and thicker the heart,and the worse the diastolic function.