The Levels And Clinical Significance Of VEDdR And RDW In Congenital Heart Disease Associated With Pulmonary Hypertension In Qinghai

Objective:This study was to explore the value of Ventricular end-diastolic diameter ratio(VEDd R)and Red blood cell distribution width(RDW)in the assessment of adult congenital heart disease associated with pulmonary artery hypertension(CHD-PAH)in Qinghai area,to provide simple and reliable indicators for the assessment of disease severity in CHD-PAH patients.Methods:A total of 105 adult CHD patients who meet the inclusion and exclusion criteria and were admitted to Hospital affiliated with Qinghai university,Qinghai Provincial People’s Hospital,Qinghai Special Hospital for Cardiovascular and Cerebrovascular Disease from January 2014 to July 2021 by echocardiography or right heart catheterization,according to whether they had pulmonary artery hypertension(PAH)and the severity of PAH they were divided into four groups,they were CHD group(33 cases),mild CHD-PAH group(27cases),moderate CHD-PAH group(27 cases)and severe CHD-PAH group(18cases),selected 31 cases of healthy subjects as control group from a medical health crowd with similar cases at the same period.General date gender,age,ethnicity,body mass index,clinical data RVEDd,LVEDd,VEDd R,LVEF,TV,ΔP,RVOT,MPAD,RDW,PDW,LDH,UA were collected for statistical analysis.Results:(1)The general date such as sex,age,ethnicity and body mass index of control group,CHD group and CHD-PAH group were not statistically significant(p>0.05),indicating that the data were comparable.(2)There were statistically significant differences in VEDd R,RDW,LDH and UA between control group,CHD group and CHD-PAH group(p<0.05),but there was no statistically significant differences in PDW among control group,CHD group and CHD-PAH group(p>0.05);VEDd R and UA in CHD group were higher than those in control group(p<0.05);VEDd R,RDW,LDH and UA in CHD-PAH group were higher than those in control group(p<0.05);VEDd R,RDW and LDH in CHD-PAH group were higher than those in CHD group(p<0.05).(3)There were statistically significant differences in VEDd R,RDW,LDH and UA among mild CHD-PAH group,moderate CHD-PAH group and severe CHD-PAH group(p<0.05).VEDd R,RDW and LDH in moderate CHD-PAH group were higher than those in mild CHD-PAH group(p<0.05);VEDd R,RDW,UA and LDH in severe CHD-PAH group were higher than those in mild CHD-PAH group(p<0.05);RDW and LDH in severe CHD-PAH group were higher than those in moderate CHD-PAH group(p<0.05).(4)Pulmonary artery systolic pressure(PASP)was moderately positively correlated with VEDd R,RDW and LDH.(5)The results of Binary Logistic regression showed that VEDd R,RDW were risk factors of CHD-PAH.(6)The sensitivity and specificity of RDW in predicting PAH in CHD patients are 55.6%and 87.9%,respectively,and when RDW>13.95%,adult CHD patients were prone to PAH.The sensitivity and specificity of VEDd R in predicting the occurrence of PAH in CHD patients were48.6%and 81.8%respectively,and when VEDd R>0.80,adult CHD patients were prone to PAH.The sensitivity,specificity and area under the curve of VEDd R combined with RDW in predicting the occurrence of PAH in CHD patients are70.8%,84.8%and 0.803.Conclusion:1.VEDd R and RDW were increased with the increase of PASP in adult patients of CHD-PAH in Qinghai area.2.VEDd R and RDW were risk factors of CHD-PAH,they can be used as simple indexes to preliminarily judge the severity of patients’ disease.