Relationship between red cell distribution width and echocardiographic parameters in patients with diastolic heart failure

Abstract

Red cell distribution width (RDW) was found to be a prognostic marker in heart failure patients. The aim of the study was to investigate the relationship between RDW and echocardiographic parameters in diastolic heart failure (DHF). Seventy-one consecutive DHF patients (26 men) and 50 controls (21 men) were included in the study. All of the study population underwent echocardiographic evaluation, and blood samples were obtained. RDW and N-terminal pro-B-type natriuretic peptide (NT-proBNP) values were significantly higher, whereas there was an increasing trend for high-sensitivity C-reactive protein levels in DHF patients than those in controls (p<0.001, p<0.001, and p=0.064, respectively). All of the echocardiographic parameters evaluating diastolic function were more deteriorated in the DHF group. Patients who had an RDW value greater than the cutoff point also had higher NT-proBNP levels, an elevated ratio of mitral peak velocity of early diastolic filling to early diastolic mitral annular velocity, and increased estimated pulmonary capillary wedge pressures by tissue Doppler parameters, but lower creatinine clearance (p<0.05 for all). According to the cutoff values calculated using receiver operating characteristic analysis, RDW>13.6% and NT-proBNP>125pg/mL have high diagnostic accuracy for predicting DHF. RDW values were increased in the DHF population. Our results suggest that the high RDW levels in patients with DHF may be related to increased neurohormonal activity, impaired renal functions, and elevated filling pressure, but not to increased inflammation.

Figure 1

Receiver operating characteristic curve showing the relationship between sensitivity and false positivity at various cutoff points for red cell distribution width (RDW) and N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) to predict diastolic heart failure.