Clinical Significance Of Red Cell Distribution Width,Cystatin C And Homocysteine In Chronic Heart Failure

Objective: Chronic heart failure(CHF)which is regarded as the end stage of a variety of cardiovascular diseases,is an important cause leading to increased mortality all over the world.This research was aimed at estimating the clinical significance of Red cell distribution width(RDW),Cystatin C(CysC)and Homocysteine(Hcy)in the patients with CHF,and exploring the correlation between the above-mentioned factors and chronic heart failure.Methods: The candidates included 200 patients who were admitted to the 4th Cardiovascular Department in The Second Affiliated Hospital of Dalian Medical University from January 2015 to January 2016.They were divided into two groups :control group(n=44)and CHF group(n=156).The CHF group was divided into three subgroups according to NYHA classification:NYHA II group(n=39),NYHA III group(n=66)and NYHA IV group(n=51).Blood sample(2-3ml)of the patients from peripheral vein at the time of admission to the hospital was collected for the measurement of Brain natriuretic peptide(BNP),and the level of RDW?CysC?Hcy?Hemoglobin(Hb)?Mean corpuscular volume(MCV),Red blood cell(RBC)?Blood lipid?Liver biochemistry and Renal function were detected in the next morning on an empty stomach.Meanwhile,left ventricular end diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF)were measured accurately by the echocardiogram.In the patients with CHF,correlation analyses were used to explore the relationship between the above-mentioned factors and BNP?LVEDD and LVEF.The data were analyzed by using SPSS 20.0 software pack.Results:1.The level of RDW?CysC and Hcy in CHF group was significantly higher compared with those in the control group respectively.(P<0.001,respectively)2.The comparison for the level of RDW?CysC and Hcy among the different cardiac function subgroups :(1)There was an ascending trend of the RDW level with the reduction of cardiac function,and the level of RDW in NYHA IV group was significantly higher than that in NYHA II?III group respectively(P<0.05,respectively).But there was no significant difference in the level of RDW between NYHA II group and NYHA III group(P=0.188);(2)The CysC level increased gradually with the reduction of cardiac function,and the level of CysC in NYHA II ? III group was significantly lower than that NYHA IV group respectively(P<0.05,respectively),however there was no significant difference in the level of CysC between NYHA II group and NYHA III group(P=0.687);(3)There was an increasing tendency of the Hcy level with deteriorative cardiac function,and the level of Hcy in NYHA IV group was significantly higher than that in NYHA II?III group respectively(P<0.05,respectively),and there was no significant difference in the level of Hcy between NYHA II group and NYHA III group(P>0.05).3.In CHF group,the level of RDW correlated positively with the level of BNP(r= 0.295,P<0.001),and correlated negatively with LVEF(r=-0.174,P=0.031)but there was no correlation between the level of RDW and LVEDD(P>0.05).4.In CHF group,the level of CysC correlated positively with the level of BNP(r= 0.317,P<0.001),but no significant relationship was found between CysC and LVEDD or LVEF respectively(P>0.05 respectively).5.In CHF group,the level of Hcy correrated positively with the level of LVEDD and BNP respectively(r= 0.222,P=0.036;r= 0.212,P=0.045 respectively),but there was no correlation between the level of Hcy and LVEF(P>0.05).6.BNP was found to be a biomarker of CHF through logistic regression analysis(OR=1.059,P<0.001),but RDW?CysC and Hcy were excluded.Conclusion:1.The level of RDW?CysC and Hcy in the patients with chronic heart failure was significantly higher than those in the control group.The above-mentionedfactors might be helpful for the early screening of CHF patients.2.There were increasing tendencies of RDW?CysC and Hcy level with impaired cardiac function in the patients with chronic heart failure,and the above-mentioned factors correlated positively with the level of BNP.The three factors might be valuable to assist the diagnosis and severity assessment of chronic heart failure.