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Red Cell Distribution Width as an Independent Predictor of Exercise Intolerance and Ventilatory Inefficiency in Patients with Chronic Heart Failure

Authors
 Sung-Jin Hong  ;  Jong-Chan Youn  ;  Jaewon Oh  ;  Namki Hong  ;  Hye Sun Lee  ;  Sungha Park  ;  Sang-Hak Lee  ;  Donghoon Choi  ;  Seok-Min Kang 
Citation
 Yonsei Medical Journal, Vol.55(3) : 635-643, 2014 
Journal Title
 Yonsei Medical Journal 
ISSN
 0513-5796 
Issue Date
2014
MeSH
Adult ; Erythrocyte Indices/physiology* ; Exercise Test ; Female ; Heart Failure/physiopathology* ; Humans ; Male ; Middle Aged ; Oxygen Consumption/physiology ; Retrospective Studies
Keywords
Cardiopulmonary exercise test ; heart failure ; red cell distribution width
Abstract
PURPOSE: Peak oxygen uptake (peak VO₂) and ventilatory inefficiency (VE/VCO₂ slope) have proven to be strong prognostic markers in patients with chronic heart failure (CHF). Recently increased red cell distribution width (RDW) has emerged as an additional predictor of poor outcome in CHF. We sought to evaluate the relationship between RDW and cardiopulmonary exercise test (CPET) parameters in CHF patients and healthy controls. MATERIALS AND METHODS: 85 ambulatory CHF patients (68 men, 54±10 years) and 107 healthy controls, who underwent a symptom-limited CPET on a treadmill according to the modified Bruce ramp protocol, were enrolled. CHF patients and healthy controls were divided into RDW tertile groups and laboratory, echocardiographic, and CPET results were analyzed. RESULTS: For patients with CHF, compared with patients in the lowest RDW tertile, those in the highest tertile had lower peak VO₂ (22 mL/kg/min vs. 28 mL/kg/min, p<0.001) and higher VE/VCO₂ slope (31 vs. 25, p=0.004). Multivariate regression analysis revealed RDW to be an independent predictor for peak VO₂ (β=-0.247, p=0.035) and VE/VCO₂ slope (β=0.366, p=0.004). The optimal cutoff value of RDW for predicting peak VO₂ ≤20 mL/kg/min and VE/VCO₂ slope ≥34 was 13.6% (sensitivity 53%, specificity 89%) and 13.4% (sensitivity 75%, specificity 82%), respectively. In contrast, for healthy controls, RDW was not related to both peak VO₂ and VE/VCO₂ slope. CONCLUSION: Higher RDW is independently related to peak VO₂ and VE/VCO₂ slope only in patients with CHF. RDW assessment, an inexpensive and simple method, might help predict functional capacity and ventilatory efficiency in these patients.
Files in This Item:
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DOI
10.3349/ymj.2014.55.3.635
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Medical Engineering (의학공학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Oh, Jae Won(오재원) ORCID logo https://orcid.org/0000-0002-4585-1488
Youn, Jong Chan(윤종찬)
Lee, Sang Hak(이상학) ORCID logo https://orcid.org/0000-0002-4535-3745
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Nam Ki(홍남기) ORCID logo https://orcid.org/0000-0002-8246-1956
Hong, Sung Jin(홍성진) ORCID logo https://orcid.org/0000-0003-4893-039X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98655
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