Cardiology Department, Quirónsalud University Hospital Madrid, Calle Diego de Velázquez, 1, 28223, Pozuelo de Alarcón, Madrid, Spain.
Cardiology Department, Ruber Juan Bravo Quirónsalud University Hospital, Calle de Juan Bravo, 49, 28006, Madrid, Spain.
High Blood Press Cardiovasc Prev. 2024 Sep;31(5):437-449. doi: 10.1007/s40292-024-00662-0. Epub 2024 Jul 20.
At the beginning of the 21st century, approximately 2.3 million US adults had atrial fibrillation (AF), and there has been a 60% increase in hospital admissions for AF. Given that the expectancy is a continuous increase in incidence, it portends a severe healthcare problem. Considerable evidence supports the immune system and inflammatory response in cardiac tissue, and circulatory processes are involved in the physiopathology of AF. In this regard, finding novel inflammatory biomarkers that predict AF recurrence after catheter ablation (CA) is a prime importance global healthcare problem. Many inflammatory biomarkers and natriuretic peptides came out and were shown to have predictive capabilities for AF recurrence in patients undergoing CA. In this regard, some studies have shown that red blood cell distribution width (RDW) is associated with the risk of incident AF. This review aimed to provide an update on the evidence of the RDW as a biomarker of red cell dysfunction and its association with high systemic inflammation, and with the risk of incident AF. Through the literature review, we will highlight the most relevant studies of the RDW related to AF recurrence after CA. Many studies demonstrated that RDW is associated with all cause-mortality, heart failure, cardiovascular disease, and AF, probably because RDW is a biomarker of red blood cell dysfunction associated with high systemic inflammation, reflecting an advanced heart disease with prognostic implications in heart failure and cardiovascular disease. Thus, suggesting that could be a potential predictor for AF recurrence after CA. Moreover, the RDW is a parameter included in routine full blood count, which is low-cost, quick, and easy to obtain. We provided an update on the evidence of the most relevant studies of the RDW related to AF recurrence after CA, as well as the mechanism of the high RDW and its association with high systemic inflammation and prognostic marker in cardiovascular disease and heart failure.
在 21 世纪初，大约有 230 万美国成年人患有心房颤动（AF），并且因 AF 住院的人数增加了 60%。鉴于发病率持续上升，这预示着一个严重的医疗保健问题。大量证据支持心脏组织中的免疫系统和炎症反应，以及循环过程参与 AF 的病理生理学。在这方面，寻找预测导管消融（CA）后 AF 复发的新型炎症生物标志物是一个首要的全球医疗保健问题。许多炎症生物标志物和利钠肽已被发现，并显示出对接受 CA 的患者 AF 复发有预测能力。在这方面，一些研究表明红细胞分布宽度（RDW）与 AF 发生的风险相关。本综述旨在提供有关 RDW 作为红细胞功能障碍的生物标志物及其与全身性炎症和 AF 发生风险的证据的最新信息。通过文献回顾，我们将重点介绍与 CA 后 AF 复发相关的 RDW 的最相关研究。许多研究表明，RDW 与全因死亡率、心力衰竭、心血管疾病和 AF 相关，这可能是因为 RDW 是与全身性炎症相关的红细胞功能障碍的生物标志物，反映了一种晚期心脏病，对心力衰竭和心血管疾病具有预后意义。因此，这表明它可能是 CA 后 AF 复发的潜在预测因子。此外，RDW 是常规全血细胞计数中的一个参数，具有成本低、快速、易于获取的特点。我们提供了与 CA 后 AF 复发相关的 RDW 的最相关研究的证据更新，以及高 RDW 的机制及其与全身性炎症和心血管疾病及心力衰竭的预后标志物的关系。
