Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 21, 2023; 29(15): 2322-2335
Published online Apr 21, 2023. doi: 10.3748/wjg.v29.i15.2322
Value of red blood cell distribution width in prediction of diastolic dysfunction in cirrhotic cardiomyopathy
Yan-Ling Chen, Zi-Wen Zhao, Shu-Mei Li, Yong-Zhe Guo
Yan-Ling Chen, Department of Gastroenterology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian Province, China
Zi-Wen Zhao, Shu-Mei Li, Yong-Zhe Guo, Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian Province, China
Author contributions: Guo YZ contributed to study conception and design; Chen YL contributed to data collection; Zhao ZW and Li SM contributed to data analysis; Chen YL contributed to first draft writing; Guo YZ contributed to paper review and editing.
Supported by the Fujian Provincial Education and Scientific Research Project, No. JAT200121; and Fujian Provincial Health Technology Project, No. 2021QNA021.
Institutional review board statement: All procedures involving animals were reviewed and approved by the Ethics Committee of Fujian Medical University Union Hospital (Approval No. 2022KY176).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong-Zhe Guo, Doctor, Attending Doctor, Department of Cardiology, Fujian Medical University Union Hospital, No. 29 Xin-Quan Road, Fuzhou 350001, Fujian Province, China. 13705935398@163.com
Received: October 14, 2022
Peer-review started: October 14, 2022
First decision: January 3, 2023
Revised: January 27, 2023
Accepted: March 15, 2023
Article in press: March 15, 2023
Published online: April 21, 2023
Processing time: 181 Days and 21.5 Hours
Abstract
BACKGROUND

Clinical diagnosis of cirrhotic cardiomyopathy (CCM) often encounters challenges of lack of timeliness and disease severity, with the commonly positive indicator usually associated with advanced heart failure.

AIM

To explore suitable biomarkers for early CCM prediction.

METHODS

A total of 505 eligible patients were enrolled in this study and divided into four groups according to Child-Pugh classification: Group I, Class A without CCM (105 cases); Group II, Class A with CCM (175 cases); Group III, Class B with CCM (139 cases); and Group IV, Class C with CCM (86 cases). Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to determine whether red blood cell distribution width (RDW) was an independent risk factor for CCM risk. The relationships between RDW and Child-Pugh scores, Model for End-Stage Liver Disease (MELD) scores, and N-terminal pro-brain natriuretic peptide (NT-proBNP) were analyzed by Pearson correlation analysis.

RESULTS

A constant RDW increase was evident from Group I to Group IV (12.54 ± 0.85, 13.29 ± 1.19, 14.30 ± 1.96, and 16.25 ± 2.13, respectively). Pearson correlation analysis showed that RDW was positively correlated with Child-Pugh scores (r = 0.642, P < 0.001), MELD scores (r = 0.592, P < 0.001), and NT-proBNP (r = 0.715, P < 0.001). Furthermore, between Group I and Group II, RDW was the only significant index (odds ratio: 2.175, 95% confidence interval [CI]: 1.549-3.054, P < 0.001), and it reached statistical significance when examined by ROC curve analysis (area under the curve: 0.686, 95%CI: 0.624-0.748, P < 0.001).

CONCLUSION

RDW can serve as an effective and accessible clinical indicator for the prediction of diastolic dysfunction in CCM, in which a numerical value of more than 13.05% may indicate an increasing CCM risk.

Keywords: Cirrhotic cardiomyopathy; Child-Pugh; Diagnosis; N-terminal pro-brain natriuretic peptide; Red blood cell distribution width

Core Tip: Diastolic dysfunction is usually an early stage of cirrhotic cardiomyopathy (CCM). This study found that red blood cell distribution width would have an advantage over N-Terminal pro-brain natriuretic peptide in indicating diastolic dysfunction in such patients, which is of great significance for the early diagnosis and treatment of CCM.