title: Red blood cell distribution width and its relation to cardiac function and biomarkers in a prospective hospital cohort referred for echocardiography.
abstract: BACKGROUND
  Red blood cell distribution width (RDW), a measure of anisocytosis, is a prognostic biomarker for heart failure (HF). However it is still unclear how RDW is associated with heart function and established cardiac biomarkers.
  
  
  RESULTS
  In a prospective hospital cohort of 296 patients referred for echocardiography because of suspected HF, blood sampling and clinical examination were performed within 24h after echocardiography. The patients were divided into four HF groups, including one group where the HF diagnosis was uncertain (gray zone). In the patients the mean age was 70 ± 11 years, 44% with systolic HF (SHF), 18% with heart failure with normal ejection fraction (HFNEF), 17% with gray zone and 21% without HF (non-HF). RDW was higher among patients with SHF and HFNEF, compared with gray zone and non-HF patients. The distribution of different variables over the RDW quartiles showed an inverse correlation between RDW levels and LVEF and a positive correlation between RDW and NT-proBNP levels. Further analysis with stepwise multiple linear regression demonstrated that NT-proBNP levels, but not LVEF, were independently correlated with RDW.
  
  
  CONCLUSIONS
  In patients referred for echocardiography because of suspected HF, RDW levels were higher in patients with SHF and HFNEF. Moreover, NT-proBNP levels were independently linked with elevated RDW.
authors.affiliation: Dept of Clinical and Molecular Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Holmström
authors.forename: Runa
authors.initials: R
authors.lastname: Sigurjonsdottir
authors.forename: Ola
authors.initials: O
authors.lastname: Hammarsten
authors.forename: Dan
authors.initials: D
authors.lastname: Gustafsson
authors.forename: Max
authors.initials: M
authors.lastname: Petzold
authors.forename: Michael L X
authors.initials: ML
authors.lastname: Fu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D015331:Cohort Studies; D004452:Echocardiography; D004909:Erythrocyte Indices; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis*; D054143:Heart Failure, Systolic / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D011446:Prospective Studies; D013318:Stroke Volume
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain