AIMS Red blood cell (RBC) distribution width (RDW) measures RBC variations in size. Higher RDW values have been associated with poor outcome in acute heart failure (HF). We aimed to assess the prognostic impact of the RDW in chronic HF. METHODS We retrospectively analysed a cohort of chronic HF patients with left ventricular systolic dysfunction followed in our HF clinic between January 2012 and May 2018. Patients with missing data concerning RDW were excluded. Patients were categorized according to RDW tertiles: ≤13.5%; between 13.5 and 14.7%; and >14.7%. Patients were followed until January 2021; all-cause mortality was the end point analysed. The association of RDW with all-cause mortality was assessed with a Cox-regression analysis. Two multivariate models were built. RESULTS We studied 860 chronic HF patients, 66.4% males, mean age 70 (standard deviation, SD 13) years. Patients were followed for a median of 49 (29-82) months. During this period, 423 (49.2%) patients died. Mortality increased with increasing RDW tertiles. Patients with RDW >14.7% had a HR of mortality of 1.95 (1.47-2.58), p < 0.001 (model 1) and of 1.81 (1.35-2.41), p < 0.001 (model 2) when compared with those with RDW ≤13.5. Patients in the second RDW tertile had an all-cause death HR of 1.47 (1.12-1.93) and of 1.44 (1.09-1.90) in models 1 and 2, respectively. CONCLUSIONS Chronic HF patients with RDW values >14.7% presented an almost 2-fold higher risk of dying in the long term than those with RDW <13.5%. RDW is a widely available and easily measured parameter that can help clinicians in the risk stratification of chronic HF patients.

中文翻译：

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红细胞分布宽度对伴有左心室功能障碍的慢性心力衰竭患者的预后影响。

目的 红细胞 (RBC) 分布宽度 (RDW) 测量红细胞大小的变化。较高的 RDW 值与急性心力衰竭 (HF) 的不良预后相关。我们的目的是评估 RDW 对慢性心力衰竭的预后影响。方法 我们回顾性分析了 2012 年 1 月至 2018 年 5 月期间在我们的心力衰竭诊所随访的一组患有左心室收缩功能障碍的慢性心力衰竭患者。排除了 RDW 数据缺失的患者。根据 RDW 三分位数对患者进行分类：≤13.5%；13.5% 至 14.7% 之间；和 >14.7%。对患者进行随访至 2021 年 1 月；全因死亡率是分析的终点。通过 Cox 回归分析评估 RDW 与全因死亡率的关联。建立了两个多元模型。结果 我们研究了 860 名慢性心力衰竭患者，其中 66.4% 为男性，平均年龄 70 岁（标准差，SD 13）岁。患者的随访时间中位数为 49 (29-82) 个月。在此期间，有 423 名患者（49.2%）死亡。死亡率随着 RDW 三分位数的增加而增加。与 RDW ≤ 13.5 的患者相比，RDW > 14.7% 的患者的死亡率 HR 分别为 1.95 (1.47-2.58)、p < 0.001（模型 1）和 1.81 (1.35-2.41)、p < 0.001（模型 2） 。在模型 1 和模型 2 中，第二个 RDW 三分位数的患者的全因死亡 HR 分别为 1.47 (1.12-1.93) 和 1.44 (1.09-1.90)。结论 RDW 值 >14.7% 的慢性心力衰竭患者的长期死亡风险比 RDW <13.5% 的患者高出近 2 倍。RDW 是一种广泛使用且易于测量的参数，可以帮助临床医生对慢性心力衰竭患者进行风险分层。