Relation Between Red Cell Distribution Width With Echocardiographic Parameters in Patients With Acute Heart Failure

Background: Red cell distribution width (RDW) has recently been discovered to be a novel prognostic marker in patients with heart failure. However, the relation between RDW and echocardiographic parameters in acute heart failure (AHF) has not been studied. Methods and Results: We analyzed laboratory findings including RDW, N-terminal pro-brain natriuretic peptide (NT-proBNP), and echocardiographic parameters in 100 patients with AHF. The mean RDW was 14.2 ± 2.0% and median NT-proBNP was 5183 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′), was 21.2 ± 9.4. When the RDW was considered in tertile categories, the highest tertile group (>14.5%) had higher E/E′ (P < .001) and higher NT-proBNP (P = .02) than the lowest tertile group (<13.2%). In multiple linear regression analysis, RDW was independently correlated with E/E′ even after adjustment of other risk factors (β-coefficient 0.431, P = .001). The optimal cutoff value of RDW for predicting E/E′ >15, suggesting elevated left ventricular filling pressure (LVFP) was 13.45% (area under the curve 0.633, P < .05). An additive power of RDW with NT-proBNP for predicting E/E′ >15 was found in logistic regression analysis (P = .038). Conclusions: We found a novel relation between higher levels of RDW and elevated E/E′ in patients with AHF. This novel finding raises the possibility that a simple marker, RDW may be associated with elevated LVFP in patients with AHF.