High Mean Corpuscular Volume Is a New Indicator of Prognosis in Acute Decompensated Heart Failure

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  • Ueda Tomoya
    First Department of Internal Medicine, Nara Medical University
  • Kawakami Rika
    First Department of Internal Medicine, Nara Medical University
  • Horii Manabu
    First Department of Internal Medicine, Nara Medical University
  • Sugawara Yu
    First Department of Internal Medicine, Nara Medical University
  • Matsumoto Takaki
    First Department of Internal Medicine, Nara Medical University
  • Okada Sadanori
    First Department of Internal Medicine, Nara Medical University
  • Nishida Taku
    First Department of Internal Medicine, Nara Medical University
  • Soeda Tsunenari
    First Department of Internal Medicine, Nara Medical University
  • Okayama Satoshi
    First Department of Internal Medicine, Nara Medical University
  • Somekawa Satoshi
    First Department of Internal Medicine, Nara Medical University Department of Regulatory Medicine for Blood Pressure, Nara Medical University
  • Takeda Yukiji
    First Department of Internal Medicine, Nara Medical University
  • Watanabe Makoto
    First Department of Internal Medicine, Nara Medical University
  • Kawata Hiroyuki
    First Department of Internal Medicine, Nara Medical University
  • Uemura Shiro
    First Department of Internal Medicine, Nara Medical University
  • Saito Yoshihiko
    First Department of Internal Medicine, Nara Medical University Department of Regulatory Medicine for Blood Pressure, Nara Medical University

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Background: Accumulating evidence suggests that hematopoiesis, especially erythropoiesis, is disturbed in heart failure (HF) for many reasons. Low hemoglobin and red blood cell distribution width have emerged as prognostic indicators of HF independent of classic predictors. The prognostic implication of mean corpuscular volume (MCV) in HF, however, is unknown. In this context, we investigated the relationship between MCV and prognosis of acute decompensated HF (ADHF). Methods and Results: This retrospective cohort study consisted of 458 consecutive patients with ADHF who had emergency admission to hospital. Patients were divided into 2 groups: MCV ≤100fl (non-macrocytic group, n=400); and MCV >100fl (macrocytic group, n=58). The relationship between MCV and all-cause death was tested using Cox proportional hazard models, adjusting for other predictors. Mean patient age was 72.4 years and mean MCV was 93.0±7.1fl. Hemoglobin was significantly lower in the macrocytic group than the non-macrocytic group. During the mean follow-up of 20.8 months, a total of 173 deaths (37.9%) occurred. Kaplan-Meier analysis showed that all-cause death was significantly higher in the macrocytic group (log-rank P<0.0001). Cox proportional hazards analysis indicated that macrocytosis was an independent predictor of all-cause death (hazard ratio, 2.288; 95% confidence interval: 1.390–3.643; P=0.0015) after adjustment in the multivariate model. Conclusions: It is proposed for the first time that MCV is an independent predictor of all-cause death in patients with ADHF.  (Circ J 2013; 77: 2766–2771)<br>

収録刊行物

  • Circulation Journal

    Circulation Journal 77 (11), 2766-2771, 2013

    一般社団法人 日本循環器学会

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