Association of the Red Cell Distribution Width with Red Blood Cell Deformability

Patel, Kushang V.; Mohanty, Joy G.; Kanapuru, Bindu; Hesdorffer, Charles; Ershler, William B.; Rifkind, Joseph M.

doi:10.1007/978-1-4614-4989-8_29

Cited by 180 publications

(164 citation statements)

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“…nutritional deficiency, and bone marrow dysfunction. Larger variation of red blood cell volume is strictly associated with decreased erythrocyte deformability, which in turn impairs blood flow through microcirculation (23). Oxidative stress was also revealed to be involved in the association between elevated RDW and clinical endpoints (24,25).…”

Section: Figurementioning

confidence: 96%

Prognostic significance of red cell distribution width in elderly patients undergoing resection for non-small cell lung cancer

et al. 2016

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Background:The impact of red cell distribution width (RDW) on outcomes in elderly patients after surgery for non-small cell lung cancer (NSCLC) is not fully understood. Methods: We retrospectively analyzed 992 NSCLC patients who underwent curative resection between 1998 and 2012. The following variables were included in the analyses to evaluate the role of RDW: age, gender, smoking index, leukocyte count, neutrophil to lymphocyte ratio (NLR), hemoglobin, platelet count, albumin, C-reactive protein, carcinoembryonic antigen, respiratory function, histology, T factor, N factor, surgical approach, surgical procedures, complications and prognosis. Results: High RDW (>13.8) was an independent risk factor for morbidity [hazard ratio (HR) 2.1; P<0.01], recurrence (HR 2.0; P=0.01), overall survival (OS) (HR 2.1; P<0.01) and disease-free survival (DFS) (HR 2.0; P<0.01) in elderly patients (age ≥75 years, n=275), whereas it was not in younger patients (age <75 years, n=717). The surgical outcome was extremely poor in those older than 80 years with a RDW greater than 15% (morbidity, 56%; postoperative stay, 23 days; OS, 24%; DFS, 0%). RDW was unaffected by age (R =0.01; P=0.86) and elevated RDW without anemia was more prognostic than high RDW due to anemia in elderly patients. Conclusions: High RDW was significantly associated with high morbidity and reduced survival in elderly patients who underwent resection for NSCLC. Therefore, this parameter should be taken into account when surgery is considered in the elderly. investigation of the etiology of anemia (1). The volume of erythrocytes is consistent, and RDW is normal in the case of anemia caused by rapid bleeding, whereas the increase of relatively large reticulocytes during the recovery process of anemia raises RDW in the case of slowly progressing anemia. RDW has recently been reported to also be an inflammatory indicator. There is mounting evidence linking elevated RDW and adverse outcomes in cardiac disease (2-4), pulmonary embolism (5), trauma (6), septic shock (7), acute pancreatitis (8), hepatitis (9), stroke (10), dementia (11), metabolic syndrome (12), and respiratory diseases such as non-small cell lung cancer (NSCLC) (13,14), chronic obstructive pulmonary disease (15), interstitial pneumonia (16) and sarcoidosis (17). High RDW has been associated with increased mortality and poor pulmonary function also in the general population (18)(19)(20).The aim of this study was to investigate the prognostic impact of RDW on outcomes in elderly patients after surgery for NSCLC. Methods Patient cohortA total of 1,061 patients with NSCLC who underwent resection at our institute between 1998 and 2012 were retrospectively analyzed. Before the study, the Research Review Board of Tokyo University examined and approved our research protocol in accordance with the Declaration of Helsinki (project approval No. 2406). All patients undergoing surgery irrespective of this study provided written informed consent for the review of their medical charts before the surgery. A total of 69...

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Section: Figurementioning

confidence: 96%

Prognostic significance of red cell distribution width in elderly patients undergoing resection for non-small cell lung cancer

et al. 2016

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“…A potentially promising, cost-effective, and high throughput method for measuring RBC deformability is microfluidics [35][36][37][38][39][40][41]. Deformability measurements using microfluidics uses minute amounts of a whole blood or RBC suspension flowing through a funnel-shaped microconstriction [42][43][44].…”

Section: Introductionmentioning

confidence: 99%

Microfluidic analysis of cellular deformability of normal and oxidatively damaged red blood cells

et al. 2013

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Microfluidic analysis of blood has potential clinical value for determining normal and abnormal erythrocyte deformability. To determine if a microfluidic device could reliably measure intra-and inter-personal variations of normal and oxidized human red blood cell (RBC), venous blood samples were collected from repeat donors over time. RBC deformability was defined by the cortical tension (pN/mm), as determined from the threshold pressure required to deform RBC through 2-2.5 lm funnel-shaped constrictions. Oxidized RBC were prepared by treatment with phenazine methosulphate (PMS; 50 mM). Analysis of the control and oxidized RBC demonstrated that the microfluidic device could clearly differentiate between normal and mildly oxidized (20.13 6 1.47 versus 27.51 6 3.64 pN/mm) RBC. In vivo murine studies further established that the PMS-mediated loss of deformability correlated with premature clearance. Deformability variation within an individual over three independent samplings (over 21 days) demonstrated minimal changes in the mean pN/mm. Moreover, inter-individual variation in mean control RBC deformability was similarly small (range: 19.37-21.40 pN/mm). In contrast, PMS-oxidized cells demonstrated a greater inter-individual range (range: 25.97-29.90 pN/mm) reflecting the differential oxidant sensitivity of an individual's RBC. Importantly, similar deformability profiles (mean and distribution width; 20.49 6 1.67 pN/mm) were obtained from whole blood via finger prick sampling. These studies demonstrated that a low cost microfluidic device could be used to reproducibly discriminate between normal and oxidized RBC. Advanced microfluidic devices could be of clinical value in analyzing populations for hemoglobinopathies or in evaluating donor RBC products post-storage to assess transfusion suitability. Am. J. Hematol. 88:682-689,

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“…It has also been reported that EPA taken up into the red blood cell membrane improves cell deformability by stabilizing the membrane. Furthermore, an increased red blood cell deformability might be associated with low RDW values 31) . Therefore, it is suggested that the reduction of cardiovascular events by the treatment with EPA may be mediated by the reduction in the RDW value via the stabilization of the red blood cell membrane.…”

Section: Discussionmentioning

confidence: 99%

Effects of puriﬁed eicosapentaenoic acid on red blood cell distribution width and vascular endothelial function in patients with coronary artery disease

et al. 2017

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Abstract:Background: Highly purified eicosapentaenoic acid (EPA) is a promising agent for the secondary prevention of coronary artery disease. Red blood cell distribution width (RDW), a measure of red blood cell size heterogeneity, has been shown to be associated with the risk of cardiovascular events in patients with coronary artery disease. In the present study, we investigated whether EPA affects red blood cell size heterogeneity and vascular endothelial function in patients with coronary artery disease. Methods and Results: Among the 30 patients with coronary artery disease with an EPA/arachidonic acid (AA) ratio <0.4, 19 patients were administered with EPA (1800 mg/d) (EPA group); the remaining 11 patients received no intervention (control group). During a follow-up period of 36±14 mo, the EPA/AA ratio increased in the EPA group (P<0.001) but did not change in the control group. The flow-mediated dilatation (FMD) value also increased in the EPA group (P<0.05) but not in the control group. The RDW value did not change in either group. In 15 patients with a baseline RDW value greater than the median (12.8), 8 in the EPA group had a decreased RDW value (P<0.05), while 7 in the corresponding control group had an unchanged RDW value. In all patients, the change in FMD was negatively correlated with that in RDW (R=−0.39, P<0.05). Conclusions: EPA improved red blood cell size heterogeneity as well as vascular endothelial function in patients with coronary artery disease. The improvements were correlated with each other.

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Association of the Red Cell Distribution Width with Red Blood Cell Deformability

Cited by 180 publications

References 10 publications

Prognostic significance of red cell distribution width in elderly patients undergoing resection for non-small cell lung cancer

Prognostic significance of red cell distribution width in elderly patients undergoing resection for non-small cell lung cancer

Microfluidic analysis of cellular deformability of normal and oxidatively damaged red blood cells

Effects of puriﬁed eicosapentaenoic acid on red blood cell distribution width and vascular endothelial function in patients with coronary artery disease

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