Relation Between Red Cell Distribution Width With Echocardiographic Parameters in Patients With Acute Heart Failure

Abstract

Background Red cell distribution width (RDW) has recently been discovered to be a novel prognostic marker in patients with heart failure. However, the relation between RDW and echocardiographic parameters in acute heart failure (AHF) has not been studied. Methods and Results We analyzed laboratory findings including RDW, N-terminal pro-brain natriuretic peptide (NT-proBNP), and echocardiographic parameters in 100 patients with AHF. The mean RDW was 14.2 ± 2.0% and median NT-proBNP was 5183 pg/mL. The mean left ventricular ejection fraction was 33.1 ± 14.5% and early mitral inflow velocity to early diastolic mitral annular velocity (E/E′), was 21.2 ± 9.4. When the RDW was considered in tertile categories, the highest tertile group (>14.5%) had higher E/E′ ( P < .001) and higher NT-proBNP ( P = .02) than the lowest tertile group (<13.2%). In multiple linear regression analysis, RDW was independently correlated with E/E′ even after adjustment of other risk factors (β-coefficient 0.431, P = .001). The optimal cutoff value of RDW for predicting E/E′ >15, suggesting elevated left ventricular filling pressure (LVFP) was 13.45% (area under the curve 0.633, P < .05). An additive power of RDW with NT-proBNP for predicting E/E′ >15 was found in logistic regression analysis ( P = .038). Conclusions We found a novel relation between higher levels of RDW and elevated E/E′ in patients with AHF. This novel finding raises the possibility that a simple marker, RDW may be associated with elevated LVFP in patients with AHF.