Red Cell Distribution Width Has a Negative Prognostic Role in Dogs with Myxomatous Mitral Valve Disease

Abstract

Red cell distribution width (RDW) is a quantitative measurement of anisocytosis. This hematological parameter is an important prognostic biomarker for different cardiovascular disorders in humans but its influence on survival has been poorly investigated in dogs with cardiovascular disease. The RDW and various clinical, complete blood count, serum biochemical and echocardiographic variables were retrospectively investigated in 146 client-owned dogs with myxomatous mitral valve disease (MMVD) at various disease stages, with or without concurrent diseases and treatment. Laboratory variables, including RDW, urea, and white blood cell (WBC), in addition to the echocardiographic variable left atrium to aorta ratio were found to be independent predictors of all-cause mortality at six months in a multivariable Cox proportional hazards regression model. In particular, the hazard ratio of RDW was 1.203 (95% confidence interval = 1.045–1.384; p = 0.010). The negative effect of increased RDW on outcome was confirmed using Kaplan–Meier curve analysis. The results of this study indicate that RDW acted as an independent predictor of negative outcome in dogs with MMVD.

Prognostic Role of Red Cell Distribution Width and Other Routine Clinico-Pathological Parameters in Dogs with Acute Pancreatitis

“…Furthermore, no correlation was found between RDW and RDW/Ca, and RBC, Hb and Hct, with the only exception of weak negative correlation between RDW and Hct. The association between RDW and regenerative anemia has been demonstrated in previous studies on dogs with various systemic and cardiovascular disorders [22][23][24][25][26][27][28][29]. Our findings suggest that the increased RDW and RDW/Ca in non-survivor dogs were not correlated to anemia and confirmed that anemia was not associated with a negative prognosis in dogs with AP [1][2][3]7].…”

“…The reference ranges of hematological variables, including RDW, can vary for different laboratories and the harmonization of red cell sizing is an issue in both human and veterinary hematology [ 35 , 45 ]. Indeed, despite the RDW cut-off of 12.7% identified in the present study falls within the reference intervals of the used instruments, the results suggest that some individuals with increased RDW values, even if within the reference intervals, may have a negative outcome, as already observed in dogs with myxomatous mitral valve disease [ 25 ].…”

“…Similar results were obtained when RDW/Ca > 1.4 was used in the multivariable model instead of RDW > 12.7% (data not shown). Two recent studies reported the relationship between increased RDW and all-cause mortality in dogs with myxomatous mitral valve disease and those hospitalized for different disorders [ 25 , 29 ]. Conversely, RDW did not predict all-cause mortality in dogs with trauma and those admitted to the intensive care unit of a referral veterinary hospital for miscellaneous disorders [ 26 , 30 ].…”

“…Among them, red cell distribution width (RDW), RDW-to-total calcium ratio (RDW/Ca), neutrophils-to-lymphocytes ratio (N/L) and platelets-to-lymphocytes ratio (P/L) have been powerfully associated with negative outcome in people with AP [ 16 , 17 , 18 , 19 , 20 , 21 ]. At present, some observational studies have investigated the role of RDW in dogs with different systemic disorders, including cardiovascular disorders (myxomatous mitral valve disease and pulmonary hypertension) [ 22 , 23 , 24 , 25 ], acute trauma, heartworm disease, and dogs admitted to intensive care unit or hospitalized for medical and surgical diseases [ 26 , 27 , 28 , 29 , 30 ], providing conflicting results. The prognostic value of RDW and RDW/Ca has been poorly investigated in dogs with AP.…”

Red Blood Cell Distribution Width as a Novel Parameter in Canine Disorders: Literature Review and Future Prospective

“…Similar to the developments in human medicine, some studies investigating the use of RDW as a novel marker have also been recently published in various animal clinical settings. In particular, these studies have been conducted in small animals with cardiovascular disease [ 10 , 11 , 12 , 13 , 14 , 15 ] and other various disorders [ 16 , 17 , 18 , 19 , 20 , 21 , 22 ]. Therefore, the aim of this review is to provide the most relevant information on RDW evaluation in the dog.…”