Relation between Red Cell Distribution Width and Left Ventricular Function in Children with Heart Failure

Background. Most of the studies done on adults showed that red cell distribution width (RDW) can be used as a prognostic marker in patients with chronic heart failure. However, RDW has not been tested in children with heart failure. Methods and Results. 31 children with heart failure admitted to Cardiology Unit, Tanta University Hospital, during the period of January 2012 to December 2012 were included in this study, RDW as a component of routine blood count was evaluated and correlated to the echocardiographic parameters of left ventricle. The mean age of our cohort was 16.16 ± 14.97 months, congenital heart disease with left-to-right shunt represented 58.1% of the underlying causes of heart failure while dilated cardiomyopathy made 41.9%. The mean hemoglobin level was 9.14 ± 1.18 gm/dL; RDW level ranged from 10.7% to 27.7% with a mean of 16.01 ± 3.34. Hemoglobin was significantly correlated with RDW at any level. For the echo parameters, at cutoff point of 16.4%, RDW was significantly correlated with fraction shortening (FS), and A, E/A ratio, but it was not correlated with LVEDD, LVESD, and E/É at the same cutoff level. Conclusion. RDW, a simple, available test, can be used as a marker for the left ventricular function in children with heart failure until an echocardiography assessment for the patients is done.

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Abstract 10960: Red Cell Distribution Width and Mortality in Cardiorenal Anemia Syndrome

Circulation ◽

10.1161/circ.132.suppl_3.10960 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Yu Lun Cheng

Keyword(s):

Heart Failure ◽

Renal Function ◽

Left Ventricular ◽

Red Cell Distribution Width ◽

Disease Stage ◽

Left Ventricular Ejection ◽

Red Cell ◽

Cell Distribution ◽

Distribution Width ◽

Study Results

Introduction: The interaction between heart failure, renal insufficiency and anemia has been termed as cardiorenal anemia (CRA) syndrome. Red cell distribution width (RDW) hasn’t been clarified of the prognostic impacts in acute heart failure (HF) with cardiorenal anemia syndrome. Hypothesis: RDW remained its prognostic predictive power in patient with cardiorenal anemia syndrome Methods: A total of 978 patients (age 75±14 years, 70% men) hospitalized for AHF were enrolled. National Death Registry was linked for the clinical outcomes of all-cause mortality. We collected data of past medical history, biochemistry profiles, and echocardiographic on admission. Results: Among the study population, 419 (43%) subjects had cardiorenal anemia syndrome. Across the tertiles of RDW distribution, high RDW was associated with lower left ventricular ejection fraction (LVEF) and hemoglobin levels, and higher serum creatinine levels. During a median follow-up duration of 31 months, 472 subjects (43%) died. The post-discharge mortality increased along with the tertiles of RDW(Figure). After accounting for age, gender, co-morbidities, hemoglobin, renal function, and sodium level, RDW remained an independent predictor of mortality (HR and 95% CI for 1% increase of RDW: 1.11; 1.07-1.15). With further adjustment of NT-proBNP, RDW still was an independent prognostic factor. With adjustments for age, sex and hemoglobin in subgroup analysis, RDW was associated with mortality in patients with chronic kidney disease stage I/II (1.09; 1.03-1.15), III (1.12; 1.06-1.19), and IV/V (1.07; 1.00-1.14). Furthermore, in patients with CRA syndrome, RDW was still related to mortality (1.07; 1.02-1.12). Conclusions: Elevated RDW is independently associated with mortality in patients hospitalized for acute HF, despite anemia status, renal function, or CRA syndrome status. Giving RDW an easily accessible marker, the study results may support RDW to improve the risk stratification of acute HF.

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