Accuracy of bioimpedance vector analysis and brain natriuretic peptide in detection of peripheral edema in acute and chronic heart failure.
To evaluate the role of bioelectrical impedance vector analysis (BIVA) and brain natriuretic peptide (BNP) in detecting peripheral congestion in heart failure (HF).



BIVA/BNP are biomarkers for congestion in acute (ADHF) and chronic HF.



487 ADHF and 413 chronic HF patients underwent BIVA and BNP tests.



BIVA was more accurate than BNP in detecting peripheral congestion both in ADHF (AUC 0.88 vs 0.57 respectively; p < 0.001) and chronic HF patients (AUC 0.89 vs 0.68, respectively; p < 0.001). In ADHF patients, the optimal BNP cut-off for discriminating presence or absence of edema was >870 pg/mL (PPV = 48% and NPV = 58%) whereas in chronic HF it was >216 pg/mL (PPV = 18% and NPV = 95%). The BIVA detected edema when the vector fell into the lower pole of 75th percentile tolerance ellipse (PPV = 84% and NPV = 78%) in ADHF, the lower pole of 50% (PPV = 68% and NPV = 95%) in chronic HF.



In HF patients, BIVA is an easy, fast technique to assess peripheral congestion, and is even more accurate than BNP.
Cardiology Section, "F. Perinei" Hospital, Bari, Italy.
Francesco
F
Massari
Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.
Massimo
M
Iacoviello
Cardiology Section, "F. Perinei" Hospital, Bari, Italy. Electronic address: piero.sc@hotmail.it.
Pietro
P
Scicchitano
Cardiology Section, IRCCS "S Maugeri" Foundation, Cassano Murge, Bari, Italy.
Filippo
F
Mastropasqua
Cardiology Section, IRCCS "S. Maugeri" Foundation, Cassano Murge, Bari, Italy.
Pietro
P
Guida
Cardiology Unit, San Camillo De Lellis Hospital, Manfredonia, Foggia, Italy.
Graziano
G
Riccioni
Heart Surgery Department, Villa ANTHEA Hospital, Bari, Italy.
Giuseppe
G
Speziale
Cardiology Section, "S. Paolo" Hospital, Bari, Italy.
Pasquale
P
Caldarola
Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.
Marco Matteo
MM
Ciccone
Emergency Department, Sant'Andrea Hospital, Medical-Surgery Sciences and Translational Medicine, University La Sapienza, Rome, Italy.
Salvatore
S
Di Somma
D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D002307:Cardiography, Impedance / Q000379:methods*; D002908:Chronic Disease; D004487:Edema / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D011379:Prognosis; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain
Acute heart failure; BIVA; BNP; Chronic heart failure; Peripheral congestion