Red Blood Cell Distribution Width Predicts Pulmonary Hypertension Secondary to Chronic Obstructive Pulmonary Disease.

Jie Yang,Zhiwei Lu,Lingling Li,Chuanmei Liu,Xiongwen Tu

doi:10.1155/2019/3853454

Abstract

Purpose This study aims at investigating the predictive value of red blood cell distribution width (RDW) in pulmonary hypertension (PH) secondary to chronic obstructive pulmonary disease (COPD). Methods 213 eligible in-hospital COPD patients were reviewed between May 2016 and May 2018, including 39 cases with PH and 174 without PH. Clinical data including demographic characteristics, comorbidities, and results of ultrasound scans, imaging examinations, and laboratory tests were recorded. Results Increased RDW level was observed in COPD patients with PH compared with COPD patients without PH, with 15.10 ± 1.72% versus 13.70 ± 1.03%, respectively (p < 0.001). RDW shared positive relationships with brain natriuretic peptide (BNP) (p=0.001, r = 0.513), pulmonary artery (PA) systolic pressure (p=0.014, r = 0.390), and PA-to-ascending aorta (A) ratio (PA : A) (p=0.001, r = 0.502). Multivariate analysis indicated that RDW, BNP, and PA : A > 1 were the independent risk factors of PH secondary to COPD (p < 0.05). The AUC of the RDW in patients with PH was 0.749 ± 0.054 (p < 0.001). The optimal cutoff value of RDW for predicting PH was 14.65, with a sensitivity and a specificity value of 69.2% and 82.8%, respectively. Conclusion RDW is significantly increased in COPD patients with PH and thus may be a useful biomarker for PH secondary to COPD.

Highlights

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the world; COPD is usually caused by exposure to noxious particles or gases and characterized by persistent airflow limitation and respiratory symptoms. [1] Pulmonary hypertension (PH) is one of the major complications of COPD and considered an independent prognostic factor for patients with COPD [2, 3].Red blood cell distribution width (RDW) is a parameter for evaluating the variability of the circulating erythrocyte volume
213 eligible cases of patients with COPD and 39 cases with PH were enrolled in this study. e clinical characteristics are shown in Table 1. e age, body mass index (BMI), length of hospital confinement, history of diabetes, hypertension, coronary artery disease (CAD), white blood cell (WBC), and N : L of the COPD patients with PH did not differ significantly from those of the COPD patients without PH
pulmonary artery (PA) enlargement is usually caused by resting PH and the centralization of blood flow caused by the destruction of the vascular bed. e PA : A measured by chest computed tomography (CT) scan is a potential predictor of PH and shares positive relationships with PA pressure in COPD patients [14, 19, 20] In addition, PA : A is dependently associated with acute exacerbations of COPD [21], and consistent with a previous study, ours found through CT that PA : A is correlated positively with pulmonary arterial pressure in patients with PH secondary to COPD

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the world; COPD is usually caused by exposure to noxious particles or gases and characterized by persistent airflow limitation and respiratory symptoms. [1] Pulmonary hypertension (PH) is one of the major complications of COPD and considered an independent prognostic factor for patients with COPD [2, 3]. [1] Pulmonary hypertension (PH) is one of the major complications of COPD and considered an independent prognostic factor for patients with COPD [2, 3]. Increasing data have indicated that RDW may be a promising predictor of the clinical outcome of cardiovascular or respiratory diseases, such as heart failure [5], PH [6], acute myocardial infarction [7], community-acquired pneumonia (CAP) [8], pulmonary embolism [9], and COPD [10, 11]. RDW is a predictor of the mortality of COPD and pulmonary arterial hypertension patients [6, 11, 12]. The prediction value of RDW in PH secondary to COPD patients is unclear. The prediction value of RDW in PH secondary to COPD patients is unclear. us, we evaluate their association in this study

Methods

Results

Conclusion