Analysis of Red Blood Cell Indices and Its Significance in Acute Decompensated Heart Failure

Author(s): Arul Murugan C. 1 , Moogaambiga S. 2 , Ranga Bashyam S.R.3

BACKGROUND Heart failure is one of important causes of significant morbidity and mortality in India. The role of red blood cell indices in the prognosis of heart failure is limited in literature. In spite of diagnostic and therapeutic advances, heart failure is associated with patient mortality. The identification and development of new therapeutic modalities of high-risk patients is important for treatment. We wanted to measure the red blood cell indices in patients with acute decompensated heart failure and evaluate its prognostic significance. METHODS This descriptive study was done in our hospital among patients suffering from acute decompensated heart failure aged less than 60 years. One hundred patients with acute decompensated heart failure have been examined. The automatic cell analyser has measured the Red Cell indices such as haematocrit (PCV), Mean Corpuscular Haemoglobin (MCH), Mean Corpuscular Volume (MCV), Red Cell Distribution Width - SD (RDW), RBC count, and haemoglobin. LV dysfunction was determined by 2D echocardiogram and categorised as mild LV dysfunction, moderate LV dysfunction, and severe LV dysfunction. For statistical analysis, the unpaired two sample t-test, analysis of variance test and Pearson correlation coefficients were used. RESULTS The MCV range in the present study was in normal range in 36 %, high in 60 % and low in 14 % of participants. In 54 % participants, PCV was normal, 23 % had abnormal PCV. RDW `SD and RDW ` CV were increased in 68 % and 64 % in the study subjects respectively. 20 % of the participants had severe, 59 % had moderate and 21 % had mild LV dysfunction respectively (p value <0.001). Average RDW SD in patients with severe LV dysfunction were 62 femtoliters, 49 FL and 47 FL in moderate and mild LV dysfunction respectively. CONCLUSIONS Red blood cell indices such as haemoglobin, PCV, MCV, RDW play a significant role in predicting heart failure prognosis. Red Cell Distribution Width (RDW) levels and MCV were increased in heart failure. High RDW correlated with more severe LV dysfunction. Treatment of anaemia with subsequent decrease of RDW contribute to improved outcome. RDW is thus a cheap and easily accessible biomarker which can be used as an early indicator of a patient's heart failure.