Association of red cell distribution width and lymphocyte count with the presence and severity of calcific aortic valve stenosis

Calcific aortic valve stenosis (CAVS) is the most common valvular heart disease in the elderly, with pathogenesis involving chronic inflammation and oxidative stress. Identifying reliable, low-cost biomarkers for disease presence and severity remains a clinical priority.

To evaluate the prognostic significance of red cell distribution width (RDW) and lymphocyte count (LC) in assessing the presence and severity of CAVS.

In this retrospective study, 377 patients with echocardiographically confirmed CAVS and 309 healthy controls were analyzed. CAVS severity was stratified as mild, moderate, or severe. RDW and LC were measured from routine blood tests. Associations with CAVS severity were examined using correlation and logistic regression analyses. ROC curve analysis assessed the predictive performance of RDW and LC for severe CAVS.

RDW levels increased progressively with CAVS severity (13.0%, 14.6%, and 15.5% for mild, moderate, and severe groups; p < 0.001), while LC decreased. RDW positively correlated with systolic transaortic gradient (r = 0.319, p < 0.001); LC was inversely correlated (r = -0.262, p < 0.001). Multivariate analysis identified RDW (OR: 2.519; 95% CI: 2.058-3.083; p < 0.001) and LC (OR: 0.261; 95% CI: 0.150-0.454; p < 0.001) as independent predictors of CAVS. RDW yielded an AUC of 0.774; LC had an AUC of 0.323.

Elevated RDW and reduced LC are independently associated with the presence and severity of CAVS. These findings suggest that these hematological indices may reflect underlying systemic processes and could serve as adjunct markers in the clinical assessment of disease burden, although their prognostic utility requires further validation.