Correlation between red blood cell distribution width and right heart failure in patients with chronic obstructive pulmonary disease / 上海交通大学学报（医学版）

ABSTRACT

Objective·To investigate the relationship between the red blood cell distribution width (RDW) and the severity of right heart failure in patients with chronic obstructive pulmonary disease (COPD). Methods?·?A total of 265 patients with simple COPD and 268 COPD patients with right heart failure admitted to Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from October 2011 to September 2016 were enrolled. According to the New York Heart Association (NYHA) criteria, all COPD patients with right heart failure were divided into Group A (ClassⅠ), Group B (Class Ⅱ), Group C (Class Ⅲ) and Group D (Class Ⅳ). The RDW, mean corpuscular volume (MCV), pro-brain natriuretic peptide, and erythrocyte sedimentation rate were measured within 24 h after admission for all patients. The RDW trends and related influencing factors in different groups were analyzed and compared. Results?·?There was no significant difference in the gender, age, forced expiratory volume in one second (FEV1), and COPD exacerbation times between the COPD group and the COPD with right heart failure group (all P>0.05). However, there was a significant difference in red blood cell count (RBC), hemoglobin, MCV, RDW, pro-brain natriuretic peptide, and arterial partial pressure of oxygen (PaO2) (all P<0.05). In COPD with right heart failure group, there was no significant difference in age, RBC, hemoglobin, MCV, and PaO2among the four groups (all P>0.05). With the increase of the patients′ NYHA functional class, both pro-brain natriuretic peptide and RDW showed a similarly significant increase (both P=0.000). Through further multiple comparisons of RDW among four groups, there was a significant difference between any two groups (all P<0.05). Conclusion?·?RDW in patients with COPD with right heart failure is significantly elevated, and is closely related to right heart failure.