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Value of red blood cell distribution width in prediction of diastolic dysfunction in cirrhotic cardiomyopathy
Yan-Ling Chen1, Zi-Wen Zhao2, Shu-Mei Li2
1Department of Gastroenterology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian Province, China.
Insights
Red blood cell distribution width (RDW) effectively predicts cirrhotic cardiomyopathy (CCM) risk. An RDW level above 13.05% indicates increased CCM risk, aiding early diagnosis and management.
Area of Science:
- Cardiology
- Hepatology
- Biomarker Discovery
Background:
- Clinical diagnosis of cirrhotic cardiomyopathy (CCM) is challenging due to lack of timeliness and disease severity indicators.
- Current diagnostic methods often identify CCM only in advanced heart failure stages.
Purpose of the Study:
- To identify suitable biomarkers for the early prediction of cirrhotic cardiomyopathy (CCM).
- To evaluate red blood cell distribution width (RDW) as an independent risk factor for CCM.
Main Methods:
- 505 patients were classified into four groups based on Child-Pugh classification and CCM presence.
- Logistic regression, ROC curve analysis, and Pearson correlation were used to assess RDW.
- RDW levels were correlated with Child-Pugh scores, MELD scores, and NT-proBNP.
Main Results:
- RDW levels consistently increased from no CCM to advanced CCM groups (Group I to IV).
- RDW showed significant positive correlations with Child-Pugh scores (r=0.642), MELD scores (r=0.592), and NT-proBNP (r=0.715).
- RDW was the sole significant predictor differentiating early CCM (Group I vs. II) with an OR of 2.175 (P<0.001).
Conclusions:
- Red blood cell distribution width (RDW) serves as an effective and accessible biomarker for predicting diastolic dysfunction in CCM.
- An RDW value exceeding 13.05% suggests an elevated risk for developing CCM.
Background:
Clinical diagnosis of cirrhotic cardiomyopathy (CCM) often encounters challenges of lack of timeliness and disease severity, with the commonly positive indicator usually associated with advanced heart failure.
Aim:
To explore suitable biomarkers for early CCM prediction.
Methods:
A total of 505 eligible patients were enrolled in this study and divided into four groups according to Child-Pugh classification: Group I, Class A without CCM (105 cases); Group II, Class A with CCM (175 cases); Group III, Class B with CCM (139 cases); and Group IV, Class C with CCM (86 cases). Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to determine whether red blood cell distribution width (RDW) was an independent risk factor for CCM risk. The relationships between RDW and Child-Pugh scores, Model for End-Stage Liver Disease (MELD) scores, and N-terminal pro-brain natriuretic peptide (NT-proBNP) were analyzed by Pearson correlation analysis.
Results:
A constant RDW increase was evident from Group I to Group IV (12.54 ± 0.85, 13.29 ± 1.19, 14.30 ± 1.96, and 16.25 ± 2.13, respectively). Pearson correlation analysis showed that RDW was positively correlated with Child-Pugh scores (r = 0.642, P < 0.001), MELD scores (r = 0.592, P < 0.001), and NT-proBNP (r = 0.715, P < 0.001). Furthermore, between Group I and Group II, RDW was the only significant index (odds ratio: 2.175, 95% confidence interval [CI]: 1.549-3.054, P < 0.001), and it reached statistical significance when examined by ROC curve analysis (area under the curve: 0.686, 95%CI: 0.624-0.748, P < 0.001).
Conclusion:
RDW can serve as an effective and accessible clinical indicator for the prediction of diastolic dysfunction in CCM, in which a numerical value of more than 13.05% may indicate an increasing CCM risk.
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