Objective. To investigate the relationship between RDW and spontaneous erythrocyte aggregation in patients with chronic heart failure (CHF). Material and methods. The study enrolled 48 patients with CHF with reduced and moderately reduced left ventricular ejection fraction (LVEF) and 11 volunteers without CVD. All participants underwent routine clinical blood count. Erythrocyte aggregation parameters were measured by laser aggregometry using the RheoScan AnD-300 aggregometer. Blood viscosity was controlled by a Lamy Rheology RM100 CP1000 rotational viscometer. Results. CHF patients demonstrated significantly higher RDW-CV (14.4 13.2; 16.2 % vs. 12.8 12.2; 13.4 %, p=0.005) and RDW-SD (48.2 45.2; 53.7 fL vs. 42.7 41.6; 44.0 fL, p=0.001) than controls. In the CHF subgroup with RDW-CV ≥ 16%, spontaneous aggregation parameters were elevated: M-index 10.8±2.0 vs. 8.9±2.0 (p=0.007), A1 0.040±0.005 vs. 0.034±0.007 (p<0.001), and combined A1+A2 0.062±0.009 vs. 0.052±0.012 (p=0.004). Regression analysis demonstrated significant associations between RDW-CV and aggregation metrics: M-index (β=0.49; 95% CI 0.08; 0.90, p=0.021), y0 (β=34.31; 95% CI 8.30; 60.32, p=0.012), and A1 (β=154.43; 95% CI 28.06; 280.79, p=0.019). Conclusion. Elevated RDW is associated with enhanced spontaneous erythrocyte aggregation in CHF patients, suggesting a possible causal role of anisocytosis in microcirculatory impairment. RDW may serve not only as a marker of cardiovascular pathology but also as a potential therapeutic and prognostic target to improve hemorheology in CHF and other CVD.
Mironov et al. (Thu,) studied this question.