Correlation Study On Relationship Between Red Blood Cell Distribution Width And Heart Failure

ObjectiveTo study the relationship between RDW and other index in patients with heart failure by large sample retrospective analysis of the patients’ blood with heart failure routine, liver and kidney function, echocardiogram index and other indexes.To improve the clinical recognition of RDW in patients with heart failure, and provide scientific basis for early diagnosis and treatment. MethodsA total of 1033 hospitalized patients with heart failure with complete clinical and laboratory data were enrolled in this study from January 2013 to December 2013 in a hospital of Tianjin. Red blood cell(RBC),hemoglobin(HGB), hematocrit(HCT),mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH),mean corpuscular hemoglobin concentration(MCHC),red blood cell distribution width-standard deviation(RDW-SD),red blood cell distribution width-coefficient of variation(RDW-CV), platelet distribution width(PDW),N-terminal pro-B-type natriuretic peptide(NTproBNP),cardiac troponin I(CTNI),myoglobin(MYO),alanine aminotransferase(ALT),aspartate aminotransferase(AST),albumin(ALB),total bilirubin(TBIL),indirect bilirubin(IBIL),direct bilirubin(DBIL),blood urea nitrogen(BUN), serum creatinine(Scr), blood uric acid(UA),left atrial diameter(LAD),left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),pulmonary artery pressure(PA)and other index were collected.Patients were divided into high RDW-CV(RDWCV>13%, 536 patients, 51.89%)group and low RDW-CV(RDW-CV≤13%, 497 patients, 48.11%) group.Also divided into NYHA I(157 patients,15.20%),NYHA II(583 patients,56.44%),NYHA III(233 patients,22.56%) and NYHA IV(60 patients, 5.80%) according to the cardiac function. 62 patients with acute myocardial infarction admission as myocardial infarction subgroup,the subgroup of patients with cardiac functional by Killp classification.48 patients of dilated cardiomyopathy complicated with heart failure were selected as dilated cardiomyopathy subgroup, while 50 patients of heart failure that do not have dilated cardiomyopathy were selected as control group. Compared the information and index between the several groups by SPSS 20.0 statistical software, got the variable quantities which had statistical significance, and analyzed which had the relationship with RDW-CV. Afterwards, did multiple linear regression analysis and got the index related to RDW-CV. Results1.RDW-CV level and its correlation between different cardiac functional grading groupsDivided into four groups according to NYHA cardiac functional grading, count statistics, high RDW-CV proportion by the grade I group of 53/157(33.76%) increased gradually to grade IV group of 44/60(73.33%), frequency distribution rate were compared using the chi square test, value is 57.020(P = 0.000),Pearson correlation coefficient set to 0.231(P = 0.000),suggesting that different classification of cardiac function group in the RDW-CV distribution is significantly different.The results showed that: with increasing NYHA classification, high RDW-CV proportion increased significantly. For observation indexes of measurement data, the variance homogeneity examination have statistically significant indicators, the single factor analysis of variance, the variance of the present study the main observation indexes of RDW-CV analysis value is 41.796(P = 0.000). The results showed that: in the four groups the RDW-CV mean at least diffient of the equal. Four groups in the RDW-CV mean both low RDW-CV group, high RDW-CV group, or total RDW-CV showed increasing trendence. Afterwards, did multiple paired comparisons by LSD.t method to the RDW-CV levels.Results showed that there has significant difference between the mean RDW-CV for each group with P<0.05,indicating that:with increas- ing NYHA classification and RDW-CV level of patients increased significantly.2.Clinical data and correlation analysis results between different RDW-CV groupsIndependent sample t test to high RDW-CV group and low RDW-CV group showed that: there has significantly statistical difference of NT-proBNP, CTNI, MYO, HGB, HCT, MCV, MCH, MCHC, RDW-SD, PDW, ALB, TBIL, DBIL, IBIL, BUN, Scr, UA, LAD, LVEDD, LVEF,PA, cardiac functional grading between two groups, P<0.05. Single factor correlation analysis using Pearson correlation formula showed that: RDW-CV was positively correlated with NT-proBNP, CTNI, MYO, RDW-SD, PDW, AST, TBIL, DBIL, IBIL, BUN, Scr, UA, LAD, LVEDD and PA, P<0.05; while negatively correlated with HGB, HCT, MCV, MCH, MCHC, ALB, LVEF, P<0.05. Multiple regression analysis to above statistically significant index showed that: RDW-CV was positively correlated with NT-proBNP, DBIL, UA, P<0.05; while negatively correlated with ALB, P<0.05.3.Correlation analysis of myocardial infarction subgroup RDW-CV and clinical indexDid single factor correlation analysis to acute myocardial infarction patients’ RDW-CV and main clinical index in subgroup. Multiple stepwise regression analysis showed that this group’s RDW-CV was negatively correlated with LVEDD, while positively correlated with UA, P<0.05.4. Comparative index analysis of dilated cardiomyopathy group and non dilated cardiomyopathygroupIndependent sample t test showed that there has significantly statistical difference of NT-proBNP, PDW-CV, PDW, AST, TBIL, IBIL, UA, LAD, LVEDD, LVEF, PA, P<0.05. Conclusion1.The level of RDW-CV in patients with different NYHA function grade were significantly different. RDW-CV increased with the increase of NYHA function grade.2.RDW-CV was significant linear correlated with NT-proBNP and can be used as a convenient and cheap test index to heart failure patients.3.RDW-CV in the patients with dilated cardiomyopathy was significantly higher than that in the control group, which indicated that RDW-CV can be used for the diagnosis of dilated cardiomyopathy complicated with heart failure.4.The significance of RDW-CV in myocardial infarction needs to be further studied.