Chen YL, Zhao ZW, Li SM, Guo YZ. Value of red blood cell distribution width in prediction of diastolic dysfunction in cirrhotic cardiomyopathy. World J Gastroenterol 2023; 29(15): 2322-2335 [PMID: 37124890 DOI: 10.3748/wjg.v29.i15.2322]
Corresponding Author of This Article
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
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
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 bythe 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
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.
