Value of red blood cell distribution width on evaluation of severity of acute heart failure in children

Abstract

Objective To investigate the correlation between red blood cell distribution width (RDW) and the cardiac function in children with acute heart failure, and to explore the clinical value in evaluating the degree of heart failure. Methods From July 2013 to October 2015, 75 cases of children with acute heart failure who were hospitalized in Chengdu Women and Children′s Central Hospital were collected and assigned as 3 groups.Heart function classification was done by using a modified Ross scoring system, and each group included 25 cases of class Ⅱ, Ⅲ, Ⅳ.Indices of red blood cell, haemoglobin, RDW, concentration of plasma N-terminal pro brain natriuretic peptide (NT-proBNP), and left ventricular ejection fraction (LVEF) were recorded.SPSS 17.0 software was statistically used for comparing each index among groups and correlation analysis. Results Red blood cells and haemoglobin were not statistically different among groups(F=0.802, 1.372, all P>0.05). RDW, NT-proBNP concentration and LVEF were significantly different among groups(F=31.388, 29.300, χ2=56.952, all P class Ⅲ group>class Ⅱ group[RDW: (16.6±1.3)%>(15.4±1.1)%>(13.9±1.3)%, NT-proBNP: (506.6±190.2) ng/L>(1 028.1±356.8) ng/L>(1 884.1±358.6) ng/L, all P<0.01]. According to LVEF=50% as the cut-off point, children with acute heart failure were divided into LVEF decreased group and LVEF retention group, former group′s RDW and NT-proBNP were significantly higher than the latter group[RDW: (16.7±1.3)% vs.(13.9±1.1)%, NT-proBNP: (1 787.4±368.6) ng/L vs.(657.4±291.1) ng/L, all P<0.01]. According to NT-proBNP levels, the children with acute heart failure were divided into low, medium, and high NT-proBNP group, and RDW in the high NT-proBNP group[(17.3±0.9)%] was significantly higher than that of medium[(15.4±0.7)%], and that of low level group[(13.7±1.2)%](all P<0.01). The correlation analysis between RDW, NT-proBNP as well as LVEF showed that RDW was significantly positive correlated with NT-proBNP (r=0.869, P<0.01), and negatively related with LVEF(r=- 0.962, P< 0.01). Conclusions RDW is closely related to the cardiac function in children with acute heart failure.RDW is increased with the aggravating of acute heart failure, which can indirectly reflect the NT-proBNP concentration and LVEF change and suggests that RDW can be used as a convenient and useful index monitoring the level of cardiac function in children with acute heart failure, and the assessment of the severity of acute heart failure. Key words: Red blood cell distribution width; Acute heart failure; N-terminal pro brain natriuretic peptide; Child