Elevated Red Cell Distribution Width Is Associated With Impaired Reverse Ventricular Remodeling and Increased Mortality in Patients Undergoing Cardiac Resynchronization Therapy

John Rickard, Dharam J. Kumbhani, Eiran Z. Gorodeski, David O. Martin, Richard A. Grimm, Patrick Tchou, Bruce D. Lindsay, W. H. Tang, Bruce L. Wilkoff

Research output: Contribution to journalArticle

16 Citations (Scopus)

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 7days 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 (<13.6). In multivariate analysis, elevated RDW was inversely associated with response (odds ratio, 0.83; 95% confidence interval, 0.69-0.99; P=.047). The presence of elevated RDW is associated with less reverse left ventricular remodeling in patients with advanced heart failure undergoing CRT.

Original languageEnglish (US)
Pages (from-to)79-84
Number of pages6
JournalCongestive Heart Failure
Volume18
Issue number2
DOIs
StatePublished - Mar 2012

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Cardiac Resynchronization Therapy
Ventricular Remodeling
Erythrocyte Indices
Mortality
Stroke Volume
Cardiac Resynchronization Therapy Devices
Heart Failure
Multivariate Analysis
Odds Ratio
Confidence Intervals

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Emergency Medicine
  • Emergency

Cite this

Elevated Red Cell Distribution Width Is Associated With Impaired Reverse Ventricular Remodeling and Increased Mortality in Patients Undergoing Cardiac Resynchronization Therapy. / Rickard, John; Kumbhani, Dharam J.; Gorodeski, Eiran Z.; Martin, David O.; Grimm, Richard A.; Tchou, Patrick; Lindsay, Bruce D.; Tang, W. H.; Wilkoff, Bruce L.

In: Congestive Heart Failure, Vol. 18, No. 2, 03.2012, p. 79-84.

Research output: Contribution to journalArticle

Rickard, John ; Kumbhani, Dharam J. ; Gorodeski, Eiran Z. ; Martin, David O. ; Grimm, Richard A. ; Tchou, Patrick ; Lindsay, Bruce D. ; Tang, W. H. ; Wilkoff, Bruce L. / Elevated Red Cell Distribution Width Is Associated With Impaired Reverse Ventricular Remodeling and Increased Mortality in Patients Undergoing Cardiac Resynchronization Therapy. In: Congestive Heart Failure. 2012 ; Vol. 18, No. 2. pp. 79-84.
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