Study Of The Significance Of Red Blood Cell Volume Distribution Width's Chang In Chronic Heart Failure Patients

Objective:To study the change of red blood cell volume distribution width (RDW) accompanied by the cardiac function's change in chronic heart failure (CHF) patients,analyse the relationship between RDW and the condition and prognosis of CHF,and to explore its possible mechanism and significance.Methods:200 chronic heart failure patients in hospital were divided into 3 groups based on New York Heart Association functional class:NYHA II group(n=75),NYHA III group (n=70),NYHA IV group(n=55),and divided into 3 groups based on left ventricular ejection fraction(LVEF):LVEF≥50% group(B group,n=107),50%>LVEF≥35% group(C group,n=50),LVEF<35% group(D group,n=43). We selected 82 patients who were not diagnosed as CHF as the control group (A group,n=82).Compared the change of RDW, NT-proBNP, LVEF in all groups.Analysed the chang of RDW,NT-proBNP before and after treatment in 26 CHF patients.Analysed the correlation of RDW and a variety of parameters by linear correlation and multiple linear stepwise regression. Assessed the value of using RDW to determine CHF by ROC curve.Results:(1)From the control group to NYHA IV group, RDW gradually increased (12.77±1.00%,13.80±0.89%,14.94±0.99%,16. 12±0.96%).There was significant difference among the four groups(P<0.01).(2)Accompanied by the decline of LVEF(from group A to D),RDW gradually increased(12.77±1.00%,14.48±1.18%,14.98±1.06%,15.99±1.34%).There was significant difference among the four groups(P<0.05). (3) Before and after treatment in 26 CHF patients, RDW was 15.44±1.17%,14.22±1.15% respectively,LgNT-proBNP was 3.46±0.42pg/ml, 3.04±0.49pg/ml respectively.They both significantly declined(P<0.001). (4) In CHF patients,there were non-linear relationship between RDW and Fe, Hb, MCV, Fib, there were significant linear correlation between RDW and age, LgNT-ProBNP, LVEF, BUN, CR, LgUA (P<0.05),r was 0.178,0.665,-0.465,0.189,0.141,0.309 respectively; The degree of correlation: LgNT-ProBNP>LVEF>LgUA>BUN>age>CR. (5) The regression equation obtained by multiple linear stepwise regression was RDW=13.734+1.518(LgNT-ProBNP)-0.026(age)―0.333(LAD)―0.012(LVEF).(6)The area under the ROC curve that RDW to determine the CHF was 0.697.The sensitivity,specificity,positive predictive value and negative predictive value of determining CHF were 46.0%,98.7%,95%, 35.59%,when the value of RDW was≥15.55%.Conclusion:①We found that RDW significantly increased in CHF patients and correlated with the degree of heart failure.②RDW has a strong correlation with LgNT-ProBNP,even stronger than the LVEF; This prompted RDW may be related to the prognosis of CHF patients.