Abstract 17988: Red Cell Distribution Width in Adults With Congenital Heart Disease: Results From the Boston Adult Congenital Heart Biobank
Introduction: There are few validated subclinical predictors of adverse clinical and surrogate outcomes in adults with congenital heart disease (CHD). Red cell distribution width (RDW) is a strong predictor of structural and functional outcomes in the non-CHD population.
Hypothesis: RDW is associated with New York Heart Association Functional Class (NYHA FC), peak oxygen consumption and minute ventilation relative to CO2 production independent of underlying congenital diagnosis and other relevant variables.
Methods: We conducted a cross-sectional study to investigate the correlation between RDW and measures of cardiometabolic status and functional capacity in adults with CHD enrolled in the Boston Adult CHD Biobank between 2012 and 2015.
Results: Among 588 adults with CHD, age averaged 38.6±13.4 years and 50.9% were female. Most common diagnoses were left sided obstructive lesions (21.6%), tetralogy of Fallot or double outlet right ventricle (20.7%), single ventricle/Fontan circulation (17.1%). Median RDW was 13.7% (interquartile range 13.3 – 14.3%). RDW correlated modestly with age (Pearson r = 0.20), hemoglobin concentration (r = -0.12), mean corpuscular volume (r = -0.44), creatinine (r = 0.28), and log C-reactive protein (r = 0.20), all p<0.01. RDW>15% (12.9% of participants) was present in only 7.5% of patients in NYHA FC I, while this figure was 23.3% for NYHA FC II and 46.4% for NYHA FC III/IV, Fisher’s exact p<0.0001. RDW was a significant predictor of peak oxygen consumption, minute ventilation relative to CO2 production and oxygen saturation, even after adjustment for demographic and clinical covariates (Table).
Conclusion: Elevated RDW is associated with impaired cardiometabolic status and functional capacity in adults with CHD. Future research should explore the biological pathways behind these observations along with their possible applications to clinical outcomes.
Author Disclosures: L. Alshawabkeh: None. N. Almaddah: None. B. Loukas: None. M.J. Landzberg: None. S. Rajpal: None. H. Stonebreaker: None. A.C. Van Riel: None. A. Valente: None. G. Ephrem: None. F. Wu: None. K. Shafer: None. A.R. Opotowsky: None.
- © 2016 by American Heart Association, Inc.