title: Relationship between red cell distribution width and right ventricular dysfunction in patients with chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is a progressively debilitating disease limiting patients' survival. The prognosis of COPD worsens with the addition of right ventricular (RV) failure. Red cell distribution width (RDW) is a measure of variability in the size of circulating erythrocytes, and is a powerful predictor of outcomes in patients with both chronic and acute left heart failure. Here we attempted to test whether RDW could provide an early marker of RV failure in patients with COPD.
  
  
  METHODS
  Thirty-nine consecutive patients with COPD were enrolled in the study. All patients had at least 10 years' history of COPD, and all were treated appropriately. Thirty-nine age-matched and sex-matched individuals were enrolled for comparison. Red cell distribution width was obtained in all patients before transthoracic echocardiography. Right ventricular parameters were evaluated, and RV failure was identified via lateral tricuspid annulus longitudinal motion and systolic-tissue Doppler velocity, using transthoracic echocardiography.
  
  
  RESULTS
  Patients with COPD had significantly higher RDW values compared with control subjects (patients with COPD, mean ± SD, 16.1 ± 2.5; range, 12.3 to 23.3; control subjects, mean ± SD, 13.6 ± 1.3; range, 11.7 to 18.3; P < .001). In multivariable logistic regression, the presence of high RDW was the only parameter independently predicting RV failure in patients with COPD (odds ratio, 2.098; P = .017). Levels of RDW, obtained before echocardiography, predicted the presence of RV failure with a sensitivity of 70% and specificity of 93.1%, with a cutoff value of >17.7.
  
  
  CONCLUSIONS
  Red cell distribution width may be used to identify COPD patients with RV failure.
authors: Department of Cardiology, Gaziantep State Hospital, Gaziantep, Turkey. isasincer@yahoo.com
authors: Isa
authors: I
authors: Sincer
authors: Ali
authors: A
authors: Zorlu
authors: Mehmet Birhan
authors: MB
authors: Yilmaz
authors: Omer Tamer
authors: OT
authors: Dogan
authors: Meltem Refiker
authors: MR
authors: Ege
authors: Gullu
authors: G
authors: Amioglu
authors: Gulay
authors: G
authors: Aydin
authors: Idris
authors: I
authors: Ardic
authors: Izzet
authors: I
authors: Tandogan
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D004912:Erythrocytes / Q000473:pathology* / Q000502:physiology; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000000981:diagnostic imaging / Q000473:pathology*; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D014463:Ultrasonography; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging / Q000473:pathology*