1. Elevated red cell distribution width is associated with impaired reverse ventricular remodeling and increased mortality in patients undergoing cardiac resynchronization therapy
- Author
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John Rickard, Richard A. Grimm, Wai Hong W Tang, David O. Martin, Eiran Z. Gorodeski, Patrick J. Tchou, Bruce D. Lindsay, Bruce L. Wilkoff, and Dharam J. Kumbhani
- Subjects
Male ,medicine.medical_specialty ,Erythrocytes ,Time Factors ,medicine.medical_treatment ,Statistics as Topic ,Cardiac resynchronization therapy ,Emergency Nursing ,Risk Assessment ,Statistics, Nonparametric ,Cardiac Resynchronization Therapy ,Internal medicine ,medicine ,Confidence Intervals ,Odds Ratio ,Humans ,cardiovascular diseases ,Ventricular remodeling ,Ohio ,Retrospective Studies ,Ultrasonography ,Ejection fraction ,Ventricular Remodeling ,business.industry ,Red blood cell distribution width ,Odds ratio ,Middle Aged ,medicine.disease ,Confidence interval ,Quartile ,Heart failure ,Multivariate Analysis ,cardiovascular system ,Emergency Medicine ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Heart Failure, Systolic - Abstract
Elevated red cell distribution width (RDW) has been associated with poor long-term outcomes in patients with systolic dysfunction. The relationship between baseline RDW and reverse ventricular remodeling in advanced heart failure patients undergoing cardiac resynchronization therapy (CRT) has not been established. The authors reviewed the pre-implant and follow-up echocardiograms of 233 patients undergoing the new implantation of a CRT device at the Cleveland Clinic between December 2001 and November 2006. Patients were included in the final cohort if they had an RDW level within 7 days of CRT implantation, a left ventricular ejection fraction (LVEF) ≤40%, and New York Heart Association class II to IV symptoms. Patients with a reduction in left ventricular end-systolic volume ≥15% following CRT were considered “responders.” Multivariate models were created to assess the relationship between baseline RDW elevation with progressive remodeling and all-cause mortality. Of 233 patients, 217 patients met inclusion criteria. Patients in the highest RDW quartile (>16.1) derived significantly less improvement in LVEF (3.5%±9.3% vs 10.1%±10.9%, P=.001) than patients in the lowest quartile (
- Published
- 2012