Value of red blood cell distribution width in prediction of diastolic dysfunction in cirrhotic cardiomyopathy

ARTICLE HIGHLIGHTS

Research background

Cirrhotic cardiomyopathy (CCM) was originally derived from studies of perioperative heart failure (HF) in liver transplant patients. In recent years, more and more researchers have found that not only patients undergoing liver transplantation, but also many patients diagnosed with cirrhosis will have cardiac insufficiency without other organic heart disease. CCM was often found in advanced cirrhosis.

Research motivation

At present, exact diagnostic criteria of echocardiography have been established for CCM. However, in most Chinese hospitals, due to high cost, echocardiography is not a good screening method for cases without clinical manifestations of HF. We are trying to find a proper method to predict CCM in order to achieve early detection and treatment.

Research objectives

To explore suitable biomarkers for early CCM prediction.

Research methods

We adopted the methods of data analysis. Under the premise of clear diagnostic criteria for CCM, risk factors were screened by multivariate regression analysis, and red blood cell distribution width (RDW), Child-Pugh classification, and N-terminal pro-brain natriuretic peptide (NT-proBNP) were analyzed by linear regression, and finally ROC curve analysis was performed to determine the critical value.

Research results

The possibility of cardiomyopathy increased (sensitivity 56.0%, specificity 71.4%) when RDW was greater than 13.05%, while the change of NT-proBNP was not significant (P = 0.114). Taken together, these findings suggest that compared with NT-proBNP, RDW can serve as a more sensitive indicator for the early stage of CCM.

Research conclusions

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.

Research perspectives

First, large-scale and multi-center studies are needed to reduce the deviation error. Second, continuous hemodynamic monitoring is necessary to further analyze the hemodynamic changes in early cirrhosis.