Agreement Between Electrophysiology Study and Tissue Doppler Imaging Regarding the Measurement of Total Atrial Conduction Time and Left Atrial Conduction Delay.

The aim of our study was to evaluate the agreement between tissue Doppler imaging (TDI) methods and electrophysiology study (EPS) concerning the measurement of total atrial conduction time (TACT) and left atrial conduction delay (LACD). Sixty-nine candidates for EPS were included. TACT and LACD were measured in the EPS. The TDI time intervals for each patient were measured using both pulsed-wave (PW) and 2-D color-coded (CC) methods, once from the beginning of the P wave to the beginning of the a' wave (Tb) and once again to the peak of the a' wave (Tp) at the mitral annulus. TACT and LACD measured by TDI were not in good agreement with those measured by EPS. There was moderate agreement between PW-Tb and CC-Tb and good agreement between PW-Tp and CC-Tp for the measurement of TACT; nevertheless, agreement was not good in the case of LACD.

Red Cell Distribution Width and Severe Left Ventricular Dysfunction in Ischemic Heart Failure.

OBJECTIVE: The red cell distribution width (RDW), a simple and widely available marker, has been linked with an increased risk of adverse outcomes in patients with heart failure (HF) and risk of death, and cardiovascular events in those with previous myocardial infarction, but its relation with the severity of left ventricular (LV) dysfunction is not fully investigated. The aim of this study was to assess the prognostic value of the RDW in post myocardial infarction patients with typical signs and symptoms of HF and with reduced LV ejection fraction (EF). METHODS: Patients (n = 350) came from an ongoing registry of consecutive patients who admitted for ischemic heart disease at our center. All patients were followed up 1 year after the initial hospitalization by telephone interviews. The outcomes studied were mortality and hospitalization because of decompensated HF. RESULTS: RDW-coefficient of variation (express in percentage) was calculated from SD of mean corpuscular volume and mean corpuscular volume itself. Using logistic regression analysis, 3 variables consisting age, RDW level, and hemoglobin were identified as independent predictors of severe LV dysfunction (LVEF <30%). Levels of RDW were associated with the presence of severe LV dysfunction, with an accuracy of 61.4% (95% confidence interval: 56.2%-66.4%) and 66.9% (95% confidence interval: 61.8%-71.6%), using cut-off values of higher than 13.5 and 13.8, respectively. CONCLUSION: Our results suggest that elevated RDW may be used as a prognostic tool among HF patients with the documented myocardial infarction because it is an inexpensive, rapidly calculated test that is already routinely in use in practice.

Effect of Baseline Red Blood Cell Distribution Width on Short- and Intermediate-term Mortality of Patients Under Primary Percutaneous Coronary Intervention: A Survival Analysis.

OBJECTIVE: Considering the limited studies specifically evaluating the role of Red blood cell distribution width (RDW) in primary percutaneous coronary intervention (PCI), we aimed to investigate the role of baseline RDW in short- and intermediate-term cardiovascular events in ST-elevation myocardial infarction patients under primary PCI. METHODS: This is a historical cohort registry analysis of 1161 patients with ST-elevation myocardial infarction under primary PCI. According to inclusion criteria, 838 patients were allocated for analysis. Patients with RDW levels of 13.6% or higher were considered as high RDW group (third tertile). All the individuals were followed up for in-hospital and 6-month mortality along with readmission and composite major adverse cardiac events. RESULTS: In-hospital deaths occurred in 53 (6.3%) patients and at 6-month follow-up 79 (9.4%) cases of mortality were documented. In-hospital and 6-month mortalities showed a significant trend in favor of high RDW group (13.3% vs. 5.9%, P = 0.003; 19.7% vs. 7.9%, P < 0.001, respectively). Multivariate analysis showed that high RDW was significantly and independently associated with higher rates of 6-month mortality (hazard ratio: 2.909; 95% confidence interval: 1.166-7.257; P = 0.022). RDW was also a significant predictor for 6-month mortality independent of anemia (hazard ratio: 2.811; 95% confidence interval: 1.047-7.551; P = 0.040). CONCLUSIONS: We found a significant association between high RDW and in-hospital and 6-month mortality as well as the occurrence of major adverse cardiac event. Meanwhile RDW was found to be a significant predictor for 6-month mortality independent of anemia. Thus, it would be beneficial to use RDW as a risk stratification index to identify high risk intent-to-treat patients.

Relationship Between Red Blood Cell Distribution Width and Mortality of Patients with Acute Myocardial Infarction Referring to Tehran Heart Center.

OBJECTIVE: Coronary heart disease is the most common cause of death in most countries and also in Iran. Among novel prognostic markers suggested in recent studies for coronary heart disease, red blood cell distribution width (RDW) has been found to be associated with poor prognosis. Therefore, we aimed to evaluate the relationship between RDW and 6-month mortality and cardiovascular events after the initial attack of myocardial infarction (MI). METHODS: Medical records of 642 patients with MI were investigated for basic and clinical characteristics, as well as patients' first hemoglobin, RDW, and mean corpuscular volume at the time of admission. Then based on patients' time of hospitalization, they were followed up by telephone for readmission and mortality 6 months later. RESULTS: Mean ± SD age of patients was 62.7 ± 12.7 years. In 6-month telephone follow-up, 443 patients (69%) had readmission. Six-month mortality occurred in 70 patients (10.9%). Patients with RDW level of 14.6% and higher were significantly older (P < 0.001). Three percent of patients with low RDW and 14.8% in high RDW group had renal failure (P < 0.001). Six-month mortality was observed in 24.3% of patients with high RDW and 7.9% of those with low RDW (P < 0.001). In multivariate logistic regression analysis, RDW (odds ratio: 1.98, 95% confidence interval: 1.06-3.68, P = 0.03), age, and ejection fraction were significant independent prognostic factors for mortality. CONCLUSIONS: Six-month mortality was significantly higher in patients with MI with high RDW. Thus given that RDW is an inexpensive and available laboratory test, it could be used for mortality risk assessment and follow up the patients for stricter control of other modifiable risk factors.