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Evaluation of red blood cell distribution width in cats with hypertrophic cardiomyopathy
G Stanzani1, R Cowlam1, K English1
1Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, AL9 7TA, UK.
Insights
Red blood cell distribution width (RDW) is higher in cats with hypertrophic cardiomyopathy and congestive heart failure (CHF). Elevated RDW independently predicts cardiac death in cats with HCM, aiding in prognosis.
Area of Science:
- Veterinary Cardiology
- Hematology
Background:
- Red blood cell distribution width (RDW) measures erythrocyte size variability.
- RDW correlates with prognosis in various human diseases, including heart failure.
Purpose of the Study:
- To investigate RDW differences in cats with hypertrophic cardiomyopathy (HCM) with or without congestive heart failure (CHF) compared to healthy controls.
- To assess RDW as a prognostic indicator for cats with HCM.
Main Methods:
- Retrospective study of 73 cats with HCM and 30 healthy controls.
- Comparison of RDW values between controls, cats with HCM without CHF, and cats with HCM and CHF.
- Survival analysis to evaluate RDW's prognostic value.
Main Results:
- RDW was significantly higher in cats with HCM and CHF compared to those with HCM alone and controls.
- RDW was significantly associated with cardiac mortality in univariable analysis.
- This association remained significant in multivariable analysis, independent of CHF, cardiac size, function, hematocrit, and pro-thrombotic state.
Conclusions:
- Increased RDW is observed in cats with CHF.
- RDW is an independent predictor of cardiac death in cats with HCM, even without other illnesses.
Background:
Red blood cell distribution width (RDW) is a measurement of variability in circulating erythrocytes size, and has recently been shown to correlate with prognosis in a variety of human diseases, including acute and chronic heart failure.
Objectives:
To determine if RDW differs between healthy controls, cats with hypertrophic cardiomyopathy (HCM) without congestive heart failure (CHF) and cats with HCM and CHF, and to evaluate whether RDW values at presentation can provide useful prognostic information in cats with HCM.
Animals:
Retrospective single-centre study. Seventy-three cats diagnosed with HCM by echocardiography and 30 healthy controls presented to a veterinary teaching hospital between October 2006 and April 2013 were included. Physical examination, haematology and echocardiographic data obtained on one single visit were retrospectively reviewed and compared between three groups: controls, cats with HCM without CHF, and cats with HCM and CHF. Outcome data were obtained from clinical records or referring veterinarians. Univariable and multivariable survival analyses were performed.
Results:
Red blood cell distribution width was significantly greater in cats with HCM and CHF compared with cats with HCM without CHF, and the controls. It was also significantly associated with cardiac mortality in univariable survival analysis, and this association remained significant in multivariable survival analysis after controlling for the effect of CHF, left atrial size, left ventricular systolic function, haematocrit and pro-thrombotic state.
Conclusions:
A higher RDW may be seen in cats with CHF and is an independent predictor of cardiac death in cats with HCM without concurrent non-cardiac-related illness.
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