The relationship between serum levels of red cell distribution width, pre - albumin and the severity of congestive heart failure patients

Abstract

Objective: To correlate red blood cell distribution width (RDW), prealbumin (PAB) with left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), and B-type natriuretic peptide (BNP) in patients with chronic heart failure and to investigate whether changes in RDW and PAB levels are associated with changes in cardiac function in patients with chronic heart failure; provide new ideas and possible mechanisms for the diagnosis, treatment, and prognosis assessment of patients with heart failure. Methods: A retrospective analysis of patients with chronic heart failure admitted to the AfÏliated Hospital of Beihua University in December 2017 and December 2018, 460 patients with chronic heart failure were analyzed retrospectively. 146 patients who were eligible for inclusion exclusion criteria were enrolled in the study. There were 79 males with an average age of 67.03±6.80 years and 67 females with an average age of 70.29±6.43 years. Grouped according to the LVEF value, LVEDD value and RDW value of the study object. All patients were enrolled in cardiac color Doppler ultrasound, 12-lead synchronized electrocardiogram, blood biochemistry and blood routine tests. Red blood cell distribution width (RDW), left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), pre-albumin (PAB), B-type Natriuritec peptide (BNP), hemoglobin (Hb), mean red blood cell volume (MCV), high-sensitivity C-reactive protein (hs-CRP). All data were entered using EXCEL software, and statistical methods were performed using SAS 9.4 statistical software. Firstly, the differences between the four groups were compared according to the patient's LVEF value, LVEDD values, and further correlation analysis was performed. Then, when the patients were grouped according to the RDW value, the differences between the four groups were analyzed. When the patients were grouped according to the PAB value, the differences between the two groups were analyzed, and the regression equation was obtained. Results: (1) According to different LVEF values of patients, from group A to group D, RDW values gradually increased with the LVEF value decreasing (13.2%, 13.7%, 14.1%, and 15.0%). The difference was statistically significant (P < 0.001). (2) According to the different LVEDD values of patients, from group A to group D, with the increase of LVEDD value, the RDW value gradually increased (13.2%, 14.0%, 14.5%, 15.0%); The differences were statistically significant (P<0.01); the difference in RDW between grades was statistically significant (P<0.001). (3) According to the different LVEF values of patients, from group A to group D, as the LVEF value gradually decreases, the PAB value gradually decreases. The difference in PAB between the two groups was statistically significant (P < 0.001). (4) In patients with chronic heart failure, there was no linear correlation between RDW levels and Hb and MCV. (5) hs-CRP is positively correlated with RDW (6) PAB levels are inversely proportional to RDW levels. (7) For each increase in the percentage of RDW, the length of hospital stay was extended by 1.32 times. Conclusion: 1. RDW levels are associated with changes in cardiac function in patients with chronic heart failure. As the LVEF value decreases, the NYHA, LVEDD, and BNP values increase gradually, and the RDW level gradually increases. A significant increase may indicate a worsening of cardiac function in patients with heart failure. 2. The predicted value of RDW is expected to be validated through more research, making it a cheap, simple predictor of clinical use of heart failure. 3. PAB levels are associated with changes in cardiac function in patients with chronic heart failure. As NYHA, the LVEF value decreased and the PAB level gradually decreased. Some of the results of this study suggest that PAB may be a valuable indicator for the diagnosis of heart failure, but requires more extensive research. 4. The association between increased RDW and hospital stay indicates that possibility of RDW could be one of the prognostic indicators.