title: Whole-body bioelectrical impedance analysis in patients with chronic heart failure: reproducibility of the method and effects of body side.
abstract: BACKGROUND
  Fluid imbalance and malnutrition have an important role in the clinical setting of chronic heart failure (CHF). Recently, tetrapolar bioelectrical impedance analysis has been suggested as an attractive method which may be used in the clinical assessment of the body composition. The aim of this study was to determine the effects of body side on whole bioelectrical impedance analysis parameters and test-retest reliability, prior to its use in a large cohort of patients.
  
  
  METHODS
  In 114 consecutive patients with CHF (mean age 65 +/- 10 years, left ventricular ejection fraction 31 +/- 9%, NYHA functional class 2.6 +/- 0.9) we measured the total body resistance, the reactance and the derived angle phase using a single-frequency (50 KHz) tetrapolar plethysmograph device. The evaluations were performed on the left and right sides of the body, in a random order, on two different occasions 30 min apart. The effects of body side were analyzed by the Student's t-test and the test-retest reliability was computed by using the coefficient of variation and intraclass correlation coefficient.
  
  
  RESULTS
  In both evaluations, the mean resistance value of the right side was significantly lower (almost 10 ohms) than that of the left side, the reactance was not different, and as a consequence the angle phase was significantly higher (almost 0.1 degrees) in the right than in the left side. The test-retest reliability for all the measurements considered was very high (the intraclass correlation coefficient ranged from 0.95 to 0.99 and the coefficient of variation from 1.7 to 4.3%).
  
  
  CONCLUSIONS
  In CHF, the body side is important for the whole-body assessment of the resistance and the angle phase, but not for reactance. In addition, all these measurements are characterized by an excellent test-retest reliability and, consequently, do not necessitate a substantial increase in the sample size for the detection of small differences in experimental studies.
authors.affiliation: Cardiology Division, Salvatore Maugeri Foundation, IRCCS, Cassano Murge, BA, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Massari
authors.forename: F
authors.initials: F
authors.lastname: Mastropasqua
authors.forename: P
authors.initials: P
authors.lastname: Guida
authors.forename: E
authors.initials: E
authors.lastname: De Tommasi
authors.forename: B
authors.initials: B
authors.lastname: Rizzon
authors.forename: G
authors.initials: G
authors.lastname: Pontraldolfo
authors.forename: M V
authors.initials: MV
authors.lastname: Pitzalis
authors.forename: P
authors.initials: P
authors.lastname: Rizzon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017097:Electric Impedance; D005260:Female; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D018401:Sample Size