Correlation Of Red Cell Distribution Width With Response To Cardiac Resynchronization Therapy

Background Cardiac resynchronization therapy(CRT)is an important means of non-medication for chronic heart failure(CHF).It can improve the symptoms of patients with heart failure,and reduce all-cause mortality in severe heart failure patients,but some patients still can not benefit from CRT,it is important to find related factors about no-response.Red cell distribution width(RDW)is a commonly used hematological parameter,it has been found that RDW has a certain value in HF patients,it can predict the poor prognosis of patients after CRT,but it is less that the study about the relevance between RDW and response after CRT.Objection To evaluate whether CRT can bring the significant clinical improvement in patients with CHF,and observe the potential risk about the non-response after CRT.Methods The clinical materials were collected from CHF patients with implantation of CRT-P/D(pacemaker/defibrillator)from October 2007 to March 2016.Analyzed the materials from the follow-up,The primary clinical end point is all-cause mortality,the second end points is rehospitalization for heart failure readmission.Divided patients into responder and non-responder,observed the difference of baseline date between these two groups.Receiver operating characteristic(ROC)curve was used for assessing predictive values of response.Results There were 45 patients were selected,The average age was(59.2±9.9)years.Average QRSd of all cases was(159.7±21.1)ms,LVEF was(29.6±5.4)%.48(71.6%)patients were responder.EF was increased to(39.1±8.5)% after CRT,LVEDD?LVEDV were also reduced,QRSd was reduced(P<0.05)after CRT,both six-minutes walking test(6MWT)and Minnesota Living with HF Questionnaire(MLHFQ)were become better(P<0.05).LVEF was(41.7±9.2)% and QRSd was(140.0±20.5)ms after CRT in responder group,but LVEF was increased to(31.4±5.7)%,QRSd was(145.4 ± 19.8)ms in non-responder group.Red cell distribution width(RDW)before CRT[OR=0.37,95%CI(0.18,0.79),P=0.009],the amount of QRS shortening(?QRSd)? QRSd before CRT?150ms has the relevance toresponse according to the logistic regression analysis(P<0.05).The cut-off point was47.7fl by the ROC curve for response associated with RDW(AUC 0.696,P=0.041).The response in RDW?47.7fl group is lower than RDW<47.7fl group(P=0.033).Conclusion CRT-P/D can relieve the symptoms and improve electrocardiogram,echocardiography parameters.RDW,?QRSd,QRSd?150ms have the correlation of non-response.RDW can predict the non-response after CRT.