Evaluation of Red Cell Distribution Width as a Screening Marker for Right Ventricular Dysfunction in Stable COPD Patients
D. Chatterjee, A.K. Janmeja, J.R. Kashyap, A. Tahlan, S. Ragaselvi
Red cell distribution width, Chronic obstructive pulm onary disease, TAPSE, S velocity, Right ventricular dysfunction
Citation Information :
Chatterjee D, Janmeja A, Kashyap J, Tahlan A, Ragaselvi S. Evaluation of Red Cell Distribution Width as a Screening Marker for Right Ventricular Dysfunction in Stable COPD Patients. Indian J Chest Dis Allied Sci 2020; 62 (1):9-12.
Objective: Right ventricular (RV) dysfunction is a commonly overlooked; but prognostically important complication of chronic obstructive pulmonary disease (COPD). Red cell distribution width (RDW) is a potential blood parameter that may have a role in the detection of RV dysfunction. The present study was conducted to evaluate the role of RDW as a screening marker for RV dysfunction in COPD.
Methods: A total of 80 consecutive stable COPD patients were enrolled. After initial spirometry, patients were screened for RV dysfunction using RDW measurement. Thereafter, two-dimensional (2D) transthoracic echocardiography (2D-TTE) was performed to confirm the RV dysfunction by measuring tricuspid annular plane systolic excursion (TAPSE) and RV lateral wall tissue doppler systolic velocity (S velocity). Sensitivity, specificity and positive and negative predictive values of RDW was calculated using 2D-TTE as the reference standard.
Results: The study cohort of COPD patients mainly comprised of middle-aged males (mean age: 57.1+9.3 years; M:F=6:1). Out of 80 patients, 26 (32.5%) had RDW above the cut-off value of 14%. On comparing them with the 10 patients (12.5%), diagnosed on 2D-TTE, RDW showed a sensitivity and specificity of 90% and 75%, respectively in detecting RV dysfunction. On multivariate logistic regression analysis, RDW was the only independent parameter predicting RV dysfunction (OR: 4.04; 95% CI: 1.5-10.5; p= 0.004) in COPD patients.
Conclusion: Red cell distribution width is a sensitive screening marker of RV dysfunction that may be incorporated in the in diagnostic algorithm of COPD patients.
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