RED CELL DISTRIBUTION WIDTH IN HEART FAILURE: A MULTIMARKER OF DIFFERENT PATHOPHYSIOLOGICAL PATHWAYS

Abstract

BackgroundRed Cell Distribution Width (RDW), a measure of the variation in volume of the red blood cells, has gained popularity in recent years as a strong prognostic marker for multiple clinical outcomes in heart failure (HF). Although many hypotheses to explain this correlation exist, the exact pathophysiological explanations remain unclear.ObjectiveWe aimed to study the relationship between RDW and multiple biomarkers in anemic and non-anemic patients with HF and reduced ejection fraction (HFrEF) using history, physical examination and echocardiographic data as well as a number of serum biomarkers in order to elucidate the pathophysiological links between RDW and HF.Methods and resultsThis report is part of the Anemia in Chronic Heart Failure: Etiology, Comparisons with Renal Disease, and Relationships with Biomarkers and Left Ventricular Remodeling (ANCHOR) study, which recruited 102 patients with HFrEF, with or without anemia in seven Canadian centers. A large number of laboratory, clinical and echocardiographic data were collected and correlations between RDW and biomarkers of interest were studied using linear and multivariate regressions. As expected, RDW was significantly higher in anemic patients compared to non-anemic patients. We identified relationships between RDW and markers of cardiac remodelling (PIIINP, osteopontin, TIMP 1, NT-proBNP, MMP-2 and troponin) renal dysfunction (creatinine, urea, potassium, EPO level, cystatin C and NGAL) markers of inflammation (sedimentation rate, HS-CRP, TGF-beta 1, IL-6 and fibrinogen) as well as markers of erythropoieitic activity (EPO level, soluble transferrin receptor and STfR-F index).Conclusion BackgroundRed Cell Distribution Width (RDW), a measure of the variation in volume of the red blood cells, has gained popularity in recent years as a strong prognostic marker for multiple clinical outcomes in heart failure (HF). Although many hypotheses to explain this correlation exist, the exact pathophysiological explanations remain unclear. Red Cell Distribution Width (RDW), a measure of the variation in volume of the red blood cells, has gained popularity in recent years as a strong prognostic marker for multiple clinical outcomes in heart failure (HF). Although many hypotheses to explain this correlation exist, the exact pathophysiological explanations remain unclear. ObjectiveWe aimed to study the relationship between RDW and multiple biomarkers in anemic and non-anemic patients with HF and reduced ejection fraction (HFrEF) using history, physical examination and echocardiographic data as well as a number of serum biomarkers in order to elucidate the pathophysiological links between RDW and HF. We aimed to study the relationship between RDW and multiple biomarkers in anemic and non-anemic patients with HF and reduced ejection fraction (HFrEF) using history, physical examination and echocardiographic data as well as a number of serum biomarkers in order to elucidate the pathophysiological links between RDW and HF. Methods and resultsThis report is part of the Anemia in Chronic Heart Failure: Etiology, Comparisons with Renal Disease, and Relationships with Biomarkers and Left Ventricular Remodeling (ANCHOR) study, which recruited 102 patients with HFrEF, with or without anemia in seven Canadian centers. A large number of laboratory, clinical and echocardiographic data were collected and correlations between RDW and biomarkers of interest were studied using linear and multivariate regressions. As expected, RDW was significantly higher in anemic patients compared to non-anemic patients. We identified relationships between RDW and markers of cardiac remodelling (PIIINP, osteopontin, TIMP 1, NT-proBNP, MMP-2 and troponin) renal dysfunction (creatinine, urea, potassium, EPO level, cystatin C and NGAL) markers of inflammation (sedimentation rate, HS-CRP, TGF-beta 1, IL-6 and fibrinogen) as well as markers of erythropoieitic activity (EPO level, soluble transferrin receptor and STfR-F index). This report is part of the Anemia in Chronic Heart Failure: Etiology, Comparisons with Renal Disease, and Relationships with Biomarkers and Left Ventricular Remodeling (ANCHOR) study, which recruited 102 patients with HFrEF, with or without anemia in seven Canadian centers. A large number of laboratory, clinical and echocardiographic data were collected and correlations between RDW and biomarkers of interest were studied using linear and multivariate regressions. As expected, RDW was significantly higher in anemic patients compared to non-anemic patients. We identified relationships between RDW and markers of cardiac remodelling (PIIINP, osteopontin, TIMP 1, NT-proBNP, MMP-2 and troponin) renal dysfunction (creatinine, urea, potassium, EPO level, cystatin C and NGAL) markers of inflammation (sedimentation rate, HS-CRP, TGF-beta 1, IL-6 and fibrinogen) as well as markers of erythropoieitic activity (EPO level, soluble transferrin receptor and STfR-F index). Conclusion