The relationship between red cell distribution width and cardiac autonomic function in heart failure

Abstract Background Both increases in red cell distribution width (RDW) levels and autonomic dysfunction are considered to be correlated with worsening heart failure. However, the relation of RDW levels to autonomic function remains uncertain. We aimed to investigate the association of RDW levels in...

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Main Authors: Shinya Yamada, Akiomi Yoshihisa, Takashi Kaneshiro, Kazuaki Amami, Naoko Hijioka, Masayoshi Oikawa, Yasuchika Takeishi
Format: Article
Language:English
Published: Wiley 2020-12-01
Series:Journal of Arrhythmia
Subjects:
Online Access:https://doi.org/10.1002/joa3.12442
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spelling doaj-9f72c171502b4d0181b9bac45515a1a22021-02-05T13:05:39ZengWileyJournal of Arrhythmia1880-42761883-21482020-12-013661076108210.1002/joa3.12442The relationship between red cell distribution width and cardiac autonomic function in heart failureShinya Yamada0Akiomi Yoshihisa1Takashi Kaneshiro2Kazuaki Amami3Naoko Hijioka4Masayoshi Oikawa5Yasuchika Takeishi6Department of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanAbstract Background Both increases in red cell distribution width (RDW) levels and autonomic dysfunction are considered to be correlated with worsening heart failure. However, the relation of RDW levels to autonomic function remains uncertain. We aimed to investigate the association of RDW levels in heart failure with autonomic function, evaluated by heart rate variability (HRV) and heart rate turbulence (HRT), and prognosis. Methods We studied 222 hospitalized patients with stable heart failure before discharge, and Holter recordings (HRV and HRT) were performed. Additionally, RDW levels were measured, and high RDW was defined as over 14.5%. We then divided the patients into two groups based on RDW levels: high RDW group (>14.5%, n = 92) and low RDW group (≤14.5%, n = 130). The relation of RDW to autonomic function and prognosis was assessed. Results In the high RDW group, severely impaired HRV and HRT were found compared to the low RDW group. In the linear regression analysis after the adjustment of multiple confounders, RDW levels were correlated with a low‐frequency (LF) to high‐frequency (HF) ratio and very low‐frequency (VLF) power (LF to HF ratio, β = −0.146, P = .027, and VLF power, β = −0.137, P = .041, respectively). During the observation period (median 1400 days), cardiac events (re‐hospitalization of heart failure, cardiac death or sudden death) were found in 73 (32.8%) patients. The Kaplan‐Meier analysis demonstrated that the high RDW group had a higher rate of cardiac events compared to the low RDW group (45.6% vs 23.8%, log‐rank P < .001). Conclusion High RDW levels were correlated with autonomic dysfunction, resulting in poor clinical outcomes.https://doi.org/10.1002/joa3.12442cardiac autonomic dysfunctionheart rate turbulenceheart rate variabilityprognosisred cell distribution width
collection DOAJ
language English
format Article
sources DOAJ
author Shinya Yamada
Akiomi Yoshihisa
Takashi Kaneshiro
Kazuaki Amami
Naoko Hijioka
Masayoshi Oikawa
Yasuchika Takeishi
spellingShingle Shinya Yamada
Akiomi Yoshihisa
Takashi Kaneshiro
Kazuaki Amami
Naoko Hijioka
Masayoshi Oikawa
Yasuchika Takeishi
The relationship between red cell distribution width and cardiac autonomic function in heart failure
Journal of Arrhythmia
cardiac autonomic dysfunction
heart rate turbulence
heart rate variability
prognosis
red cell distribution width
author_facet Shinya Yamada
Akiomi Yoshihisa
Takashi Kaneshiro
Kazuaki Amami
Naoko Hijioka
Masayoshi Oikawa
Yasuchika Takeishi
author_sort Shinya Yamada
title The relationship between red cell distribution width and cardiac autonomic function in heart failure
title_short The relationship between red cell distribution width and cardiac autonomic function in heart failure
title_full The relationship between red cell distribution width and cardiac autonomic function in heart failure
title_fullStr The relationship between red cell distribution width and cardiac autonomic function in heart failure
title_full_unstemmed The relationship between red cell distribution width and cardiac autonomic function in heart failure
title_sort relationship between red cell distribution width and cardiac autonomic function in heart failure
publisher Wiley
series Journal of Arrhythmia
issn 1880-4276
1883-2148
publishDate 2020-12-01
description Abstract Background Both increases in red cell distribution width (RDW) levels and autonomic dysfunction are considered to be correlated with worsening heart failure. However, the relation of RDW levels to autonomic function remains uncertain. We aimed to investigate the association of RDW levels in heart failure with autonomic function, evaluated by heart rate variability (HRV) and heart rate turbulence (HRT), and prognosis. Methods We studied 222 hospitalized patients with stable heart failure before discharge, and Holter recordings (HRV and HRT) were performed. Additionally, RDW levels were measured, and high RDW was defined as over 14.5%. We then divided the patients into two groups based on RDW levels: high RDW group (>14.5%, n = 92) and low RDW group (≤14.5%, n = 130). The relation of RDW to autonomic function and prognosis was assessed. Results In the high RDW group, severely impaired HRV and HRT were found compared to the low RDW group. In the linear regression analysis after the adjustment of multiple confounders, RDW levels were correlated with a low‐frequency (LF) to high‐frequency (HF) ratio and very low‐frequency (VLF) power (LF to HF ratio, β = −0.146, P = .027, and VLF power, β = −0.137, P = .041, respectively). During the observation period (median 1400 days), cardiac events (re‐hospitalization of heart failure, cardiac death or sudden death) were found in 73 (32.8%) patients. The Kaplan‐Meier analysis demonstrated that the high RDW group had a higher rate of cardiac events compared to the low RDW group (45.6% vs 23.8%, log‐rank P < .001). Conclusion High RDW levels were correlated with autonomic dysfunction, resulting in poor clinical outcomes.
topic cardiac autonomic dysfunction
heart rate turbulence
heart rate variability
prognosis
red cell distribution width
url https://doi.org/10.1002/joa3.12442
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