title: Detection of preclinical body fluid retention in established heart failure patients during follow-up by a digital weight scale incorporating a bioelectrical impedance analyzer.
abstract: This study examined the characteristics of asymptomatic worsening heart failure (HF) events and validated the role of a novel HF monitoring method (measuring body weight [BW] and percent body fat [BF%]) to identify such worsening HF events. A clinician determined worsening HF status by evaluating symptoms, physical signs, and pleural effusion on ultrasonography. A criterion of significant fluid weight gain was defined as BW gain ≥1.5 kg with a concomitant decrease in BF%. A total of 74 HF patients were included. During a mean follow-up of 20.8 months, 1588 visits were evaluated. A total of 79 worsening HF events occurred in 50 patients, in which worsening was symptomatic in 46 events (58%) and asymptomatic in 33 events (42%). Novel method eliminated 42 of 73 (58%) false-positive indications of worsening HF events based only on the BW criterion (≥1.5 kg) without excluding true worsening HF events. The test characteristics of this method in the diagnosis of overall HF events were sensitivity 65.8% (95% confidence interval [CI], 54.3-76.1), specificity 97.9% (95%, CI 97.1-98.6), positive predictive value 62.7% (95% CI, 51.3-73.0), and negative predictive value 98.2% (95% CI, 97.4-98.8). Preclinical fluid retention occurs frequently in established HF patients, and novel monitoring method can specifically identify preclinical worsening HF.
authors.affiliation: Division of Internal Medicine, Nishida Hospital, Oita, Japan. hkata@cream.plala.or.jp
authors.forename: Hajime
authors.initials: H
authors.lastname: Kataoka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001826:Body Fluids; D001835:Body Weight; D017097:Electric Impedance; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity