Whole body bioimpedance monitoring for outpatient chronic heart failure follow up.
BACKGROUND
Although cardiac output index (CI), stroke volume index (SVI), and total systemic vascular resistance (TSVR) are important hemodynamic parameters for the prognosis of chronic heart failure (CHF), they are difficult to measure in an outpatient setting. Whole body bioimpedance monitoring using a Non-Invasive Cardiac System (NICaS) allows for easy, non-invasive estimation of these parameters. Here, whether NICaS-derived hemodynamic parameters are clinically significant was investigated by relating them to other conventional cardiovascular functional indices, and by evaluating their predictive accuracy for CHF readmission.


RESULTS
Study subjects of 68 patients with CHF were enrolled in the study immediately upon discharge from the hospital. NICaS-derived CI, -SVI, and -TSVR values obtained at an outpatient clinic were significantly related with left ventricular ejection fraction (LVEF) measured by echocardiography, serum B-type natriuretic peptide (BNP), and exercise tolerance. During the 100 +/-98 days follow-up, 15 patients were readmitted to our hospital for CHF recurrence. Multivariate analysis indicated that LVEF, NICaS-derived CI, NICaS-derived SVI, and plasma BNP were significant indicators (receiver operating characteristic curve cut-off point, LVEF: 37%, NICaS-derived CI: 2.49L x min-1 x m(-2), NICaS-derived SVI: 27.2 ml/m(2), plasma BNP: 344 pg/ml) for readmission.


CONCLUSIONS
Hemodynamic parameters derived by NICaS are applicable for the non-invasive assessment of cardiac function in outpatient CHF follow up.
Tanino
Yusuke
Y
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Shite
Junya
J
Paredes
Oscar L
OL
Shinke
Toshiro
T
Ogasawara
Daisuke
D
Sawada
Takahiro
T
Kawamori
Hiroyuki
H
Miyoshi
Naoki
N
Kato
Hiroki
H
Yoshino
Naoki
N
Hirata
Ken-ichi
K
D000368:Aged; D002302:Cardiac Output / Q000502:physiology; D002908:Chronic Disease; D017097:Electric Impedance; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010045:Outpatients; D011379:Prognosis; D013318:Stroke Volume / Q000502:physiology; D014655:Vascular Resistance / Q000502:physiology
D020097:Natriuretic Peptide, Brain