Background: Red cell distribution width (RDW) is recently discovered to be a novel prognostic marker in patients (pts) with heart failure. However, the underlying mechanism of this novel finding is unknown. We tested the hypothesis that higher levels of RDW were associated with hemodynamic echo-parameters in pts with acute heart failure (AHF).
Methods and Results: We analyzed routine laboratory findings including N-terminal pro-brain natriuretic peptide (NT-proBNP) and echocardiographic parameters in 100 hospitalized AHF pts including ischemic or nonischemic etiology (60 males, 64.3 ± 13.1 years old). In our study, mean RDW was 14.2 ± 2.0 % and median NT-proBNP was 5183 (1912.75 to 11204.75) 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’), noninvasive echo-parameter for left ventricular filling pressure (LVFP), was 21.2 ± 9.4 respectively. RDW was significantly correlated with log NT-proBNP (r=0.315, p=0.004), hemoglobin (r=-0.387, p<0.001), estimated glomerular filtration rate (r=-0.214, p=0.033), left atrial volume index (r=0.411, p<0.001), and E/E’ (r=0.477, p<0.001). In multiple linear regression analysis, RDW was independently correlated with E/E’ even after adjustment for other risk factors (beta coefficient= 0.459, p<0.001). The optimal cutoff value of RDW for predicting E/E’ >15 was 13.45 % (AUC 0.633, 95 % CI 0.512 to 0.754, sensitivity 63 %, specificity 55.6 %, p<0.05).
Conclusion: We found a novel relation between higher levels of RDW and elevated E/E’ in pts with AHF. This novel finding raises the possibility that a simple serum marker, RDW may be associated with elevated LVFP in pts with AHF.
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