Study Of Relationship Of Red Cell Distribution Width And Chronic Heart Failure

Chronic heart failure(CHF) is the final pathological outcome of several primary cardiovascular disorders. It is acompanied by increasing morbidity every year and bad prognosis, so threatening people`s healthy. Until now, there has not been a"gold standard"for diagnosis of heart failure. We still daignose heart failure mainly by symptom, sign and ultrasongraphy. In the last decade, the researches focoused on the relationgship of anemia and heart failure. They found that anemia is prevelant in heart failure, positively correlated with the degree of heart failure and anemia is an independent risk factor for heart failure. The rearch from CHARM programme found that increased red cell distribution width (RDW)was a strong independent predictor of greater morbidity and mortality in patients with chronic heart failure. Compared with many other greater clinical and laboratory parameters, RDW was a more stronger prognostic marker even after adjusting for hemoglobin.RDW is a quantitative measure of anisocytosis, the variability in size of the circulating erythrocytes. It is routinely measured by automated hematology analyzers and is reported as a component of the complete blood count. There hasn`t been any study about whether RDW correlate with the degree of heart failure and whether it has diagnosic value in heart failure.The study will discuss the correlation of RDW and NYHA functional class,analyse the main factors that influence RDW and evaluate the its diagnosic value in chronic heart failure.Objective:To discuss the correlation of RDW and chronic heart failure,the main factors that influence RDW and the significance in classfication of chronic heart failure.Method:In the study we selected 289 inpatients diagnosid as chronic heart failure admitted from January of 2007 to March of 2008 as the chronic heart failure group.Then divided the patients into three groups according to NYHA functiongal class: NYHA II group, NYHA III group and NYHA IV group. We selected 50 patients who were not diagnosed as CHF as the control group. Patients with diabetes, hemorrhage, malignant tumor, hematologic disease, chronic obstructive pulmonary disease, serious liver and kidney dysfunction, autoimmune diseases were excluded. All the peoples were accepted blood routine test, clinical biochemical test and color doppler ultrasound to measure RBC, Hb, RDW, BUN, Cr, LVEDD, LVEF. Compared RDW between the CHF group and control group, analysed the correlation of RDW and NYHA functional class, and study the relationship of RDW and age, blood routine test index(RBC, Hb),clinical biochemical test index (BUN, Cr) and ultrasonic index(LVEDD, LVEF) using multiple linear stepwise regression.Results:(1)RDW between CHF group and control group: RDW of control group was 13.23±0.72% and that of CHF group is 14.15±1.78%. RDW of CHF group was higher than that of cintrol group, the difference was significant(P<0.01).(2)The comparision of RDW in different NYHA functional class: NYHA II～IV group, RDW was repectively 13.46±0.81%,14.08±1.41%,15.27±2.73%. RDW inceresed with NYHA functional increased. There was significant difference among the three groups(P<0.01). RDW positively correlated with NYHA functional class(Pearson correlation coefficient was 0.363, P<0.001).(3)The raltionship of RDW and LVEDD,LVEF,RBC,Hb,BUN,Cr: the liner dependence relationgship between RDW and age, LVEDD, RBC, Cr was poor. The regression coefficient was respectively -0.088,0.023,0.12, P>0.05. However the liner dependence relationgship of RDW and BUN, Hb, LVEF was good, the standard coefficient was respectively 0.25,-0.252,-0.18,P<0.01. The regression equation was RDW=17.725+0.136(BUN)-0.025(Hb)-0.02(LVEF).In summary, we found that RDW increased in chronic heart failure patients and correlated with the degree of heart failure. BUN, Hb, LVEF were the main factors that influence RDW. RDW, as a routinely measured index, invasive and could be easily measured, not only could be a prognosic marker, but also could be a objective index for enriching the diagnosis of chronic heart failure and evaluation of severity of heart failure.