红细胞分布宽度及其与前瞻性医院队列超声心动图检查患者心功能和生物标志物的关系。

Red blood cell distribution width and its relation to cardiac function and biomarkers in a prospective hospital cohort referred for echocardiography.

机构信息

Dept of Clinical and Molecular Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

出版信息

Eur J Intern Med. 2012 Oct;23(7):604-9. doi: 10.1016/j.ejim.2012.05.005. Epub 2012 May 28.

DOI:10.1016/j.ejim.2012.05.005

PMID:22939804

Abstract

BACKGROUND

Red blood cell distribution width (RDW), a measure of anisocytosis, is a prognostic biomarker for heart failure (HF). However it is still unclear how RDW is associated with heart function and established cardiac biomarkers.

METHODS AND RESULTS

In a prospective hospital cohort of 296 patients referred for echocardiography because of suspected HF, blood sampling and clinical examination were performed within 24h after echocardiography. The patients were divided into four HF groups, including one group where the HF diagnosis was uncertain (gray zone). In the patients the mean age was 70 ± 11 years, 44% with systolic HF (SHF), 18% with heart failure with normal ejection fraction (HFNEF), 17% with gray zone and 21% without HF (non-HF). RDW was higher among patients with SHF and HFNEF, compared with gray zone and non-HF patients. The distribution of different variables over the RDW quartiles showed an inverse correlation between RDW levels and LVEF and a positive correlation between RDW and NT-proBNP levels. Further analysis with stepwise multiple linear regression demonstrated that NT-proBNP levels, but not LVEF, were independently correlated with RDW.

CONCLUSION

In patients referred for echocardiography because of suspected HF, RDW levels were higher in patients with SHF and HFNEF. Moreover, NT-proBNP levels were independently linked with elevated RDW.

摘要

背景

红细胞分布宽度（RDW）是一种不均一性的指标，是心力衰竭（HF）的预后生物标志物。然而，RDW 与心脏功能和已建立的心脏生物标志物的关联仍不清楚。

方法和结果

在一个 296 名因疑似 HF 而行超声心动图检查的前瞻性医院队列中，在超声心动图检查后 24 小时内进行了血液采样和临床检查。患者被分为四个 HF 组，其中一组 HF 诊断不确定（灰色区域）。在患者中，平均年龄为 70±11 岁，44%为收缩性 HF（SHF），18%为射血分数正常的心力衰竭（HFNEF），17%为灰色区域，21%无 HF（非 HF）。与灰色区域和非 HF 患者相比，SHF 和 HFNEF 患者的 RDW 更高。不同变量在 RDW 四分位数上的分布显示，RDW 水平与 LVEF 呈负相关，与 NT-proBNP 水平呈正相关。进一步的逐步多元线性回归分析表明，NT-proBNP 水平而不是 LVEF 与 RDW 独立相关。