Mean corpuscular haemoglobin concentration and outcomes in heart failure with preserved ejection fraction

Abstract

Aims This study aims to evaluate the prognostic value of mean corpuscular haemoglobin concentration (MCHC) on clinical outcomes in patients with heart failure with preserved ejection fraction (HFpEF). Methods and results We analysed HFpEF participants from the Americas in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial with available baseline data ( n = 1747). Patients were grouped into hypochromia or non‐hypochromia group according to a MCHC cut‐off level of 330 g/L. Cox proportional hazard model was used to explore the prognostic value of hypochromia on the long‐term clinical outcomes (the primary endpoint [composite of cardiovascular mortality, HF hospitalization and aborted cardiac arrest], any‐cause and HF hospitalization, all‐cause and cardiovascular mortality). Patients were further stratified according to baseline estimated glomerular filtration rate (eGFR) to explore the impact of renal dysfunction on the prognostic value of hypochromia. Baseline hypochromia was prevalent ( n = 662, 37.9%) and strongly associated with worse clinical outcomes. In patients with worse renal function (eGFR < 60 mL/min per 1.73 m 2 ), hypochromia was independently associated with primary endpoint (hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.23–1.98; P < 0.001), any‐cause hospitalization (HR, 1.43; 95% CI, 1.20–1.71, P < 0.001) and HF hospitalization (HR, 1.40; 95% CI, 1.07–1.84; P = 0.015), whereas no significant association between hypochromia and these outcomes was found in patients with better renal function. Conclusions Among HFpEF patients, hypochromia (i.e. MCHC ≤ 330 g/L) is independently associated with adverse clinical outcomes, especially when in the presence of co‐morbidity renal dysfunction.

Hemoglobin specific volume width might promote the prevalence and poor long-term prognosis of American cardiovascular disease adult patients: the NHANES 1999-2020

“…Morteza et, al . 35 compared various RBC indices to predict a 12-month prognosis in heart failure. Among the above, the MCHC was the most sensitive index, and RDW was the most specific 35 .…”

“…For example, RDW 33 and MCHC 34 have already been recognized as diagnostic indicators of anaemia, and HSW is calculated from MCHC and RDW. MCHC mirrors the haemoglobin concentration and is related to an adverse poor prognosis in heart failure 35 (a subtype of CVD). Higher RDW 36 mirrors the potential deregulation of RBC balance, including weakened erythropoiesis and disorder RBC survival.…”

“…Other information among the quartiles of HSW among these CVD patients is shown in Table 5. The mortality rates of the Q1, Q2, Q3, and Q4 were 35.80%, 41.77%, 35.28%, and 43.68% (P<0.001). Mortality fluctuates as the quantile of HSW increases.…”

Nomograms for Predicting the Risk of Acute Heart Failure in ICU Patients with Atrial Fibrillation: A Retrospective Cohort Study

“…Our model 1 showed that greater fluid management increases the risk of AHF. Relative erythrocyte hypochromia, which manifests as a low MCHC, affects the onset of AHF [40, 41]; a decrease in the MCHC corresponds to an increase in the risk of AHF. The serum bicarbonate level also significantly increases in patients with AHF [42], and it can serve as a predictive indicator.…”

Hemoglobin specific volume width promotes the prevalence and poor long-term prognosis of American adult hypertensive patients: the NHANES 1999-2020

“…as diagnostic indicators of anaemia, and HSW is calculated from MCHC and RDW. MCHC mirrors the haemoglobin concentration and is related to an adverse poor prognosis in heart failure 29 . Higher RDW 2 mirrors the potential deregulation of RBC balance, including weakened erythropoiesis and disorder RBC survival.…”