The Clinical Study Of Red Blood Cell Distribution Width In Chronic Heart Failure

Objective： To investigate the association between red blood cell distributionwidth(RDW) level and the change of cardiac function in patients with chronic heart failure(CHF) and explore its possible mechanism by studying the correlation between RDW andleft ventricular ejection fraction(LVEF)， left ventricular end-diastolic dimension(LVEDD) and high-sensitivity C-reactive protein(hsCRP) and uric acid(UA) in patientswith chronic heart failure. Methods：Nine hundred and seventy-four patients with chronicheart failure in our hospital between January2009and June2011were analysedretrospectively. Of nine hundred and seventy-four patients with chronic heart failure, twohundred and eighty patients were included in our study accorded with inclusion andexclusion criteria. The patients in this study included160men (mean age56.36±6.70years old) and120women (mean age62.36±6.63years old). According to the differentLVEF、 LVEDD and RDW, the patients were divided into groups respectively. Eachpatient received examinations of echocardiography、electrocardiogram（ECG）、bloodroutine and blood biochemistry. RDW、LVEF、LVEDD、Hb、MCV、hs-CRP and UA wereanalysed. EXEL was used for all date transcription. Date analysis was performed by usingthe Statistical Package for Social Sciences(SPSS17.0). First,compare the differences in thestudy variables across LVEF and LVEDD quartiles respectively and use correlationanalysis；and then compare the differences in the study variables across RDW quartiles,and use correlation analysis analysed the correlation of RDW and a variety of parametersby linear correlation and multiple linear stepwise regression.Results:(1) According to thedifferent LVEF,from group A to group D, with a progressive decrease in LVEF, RDWlevel increased gradually(13.48%±0.85%、14.10%±1.46%、14.59%±1.59%、14.75%±1.42%respectively).There was significant difference among the four groups(P＜0.01). RDW level correlated inversely with LVEF, R=－0.538(P＜0.01,).(2) Accordingto the different LVEDD, from group a to group d, with a progressive increase in LVEDD, RDW level increased gradually(13.53±0.91%，14.12±1.42%，14.60±1.68%，14.76±1.39%respectively).There was significant difference among the four groups(P＜0.01). RDWlevel correlated positively with LVEDD, R=－0.343,P＜0.01,).(3)In chronic heart failurepatients，there were non-linear relationship between RDW and Hb、MCV，there weresignificant linear correlation between RDW and hs-CRP、LgUA (P＜0.05), r was0.486、0.513respectively. The degree of correlation was LgUA＞hs-CRP.(4) The regressionequation obtained by multiple linear stepwise regression was RDW=13.309―0.027（LVEF）+0.112(hs-CRP)+0.003（LgUA）. Conclusion：RDW correlated with thechange of cardiac function in patients with chronic heart failure, with a progressivedecrease in LVEF and a progressive increase in LVEDD, RDW level increased gradually.RDW had a strong correlation with hs-CRP、LgUA. This indicates that RDW levelincrease may be related to the inflammation and oxidative reaction in patients with chronicheart failure.