title: The Combyn™ ECG: Adding haemodynamic and fluid leads for the ECG. Part II: Prediction of total body water (TBW), extracellular fluid (ECF), ECF overload, fat mass (FM) and "dry" appendicular muscle mass (AppMM).
abstract: Simultaneous with a 12 channel ECG, body composition was analysed by segmental multi-frequency impedance analysis in 101 healthy subjects and in 118 patients with chronic heart failure (CHF, n= 40), chronic renal failure with haemodialysis (HD, n= 20), and miscellaneous internal diseases (n= 58). Whole body DXA and sodium bromide dilution were used as reference methods for total body water (TBW), extracellular fluid (ECF), appendicular muscle mass (AppMM) and fat mass (FM). Empirical prediction equations were developed in a randomized evaluation sample and then evaluated in unknowns. TBW, ECF, AppMM and FM could be predicted with regression coefficients of 0.96, 0.90, 0.95 and 0.93, respectively, all with p< 0.001. Only segmental impedances and height, but not age, sex, weight and BMI contributed to the prediction of water compartments. About half the patients with CHF and half of those on HD showed increased ECF/ICF ratio in relation to % FM at the legs but not at the thorax. The predicted AppMM was additionally corrected for increased ECF to determine "dry AppMM", which is markedly lower than the misleading reference DXA. This methodology shows promise as a combination of routine ECG with measurement of body composition, assessment of sarcopenia and detection of overhydration.
authors.affiliation: Institute of Cardiovascular and Metabolic Medicine, Mariatrosterstr 67, A 8043 Graz, Austria. Electronic address: falko.skrabal@medunigraz.at.
authors.forename: Falko
authors.initials: F
authors.lastname: Skrabal
authors.affiliation: Institute of Cardiovascular and Metabolic Medicine, Mariatrosterstr 67, A 8043 Graz, Austria.
authors.forename: Georg P
authors.initials: GP
authors.lastname: Pichler
authors.affiliation: Institute of Cardiovascular and Metabolic Medicine, Mariatrosterstr 67, A 8043 Graz, Austria.
authors.forename: Mathias
authors.initials: M
authors.lastname: Penatzer
authors.affiliation: Institute of Cardiovascular and Metabolic Medicine, Mariatrosterstr 67, A 8043 Graz, Austria.
authors.forename: Johannes
authors.initials: J
authors.lastname: Steinbichl
authors.affiliation: Institute of Cardiovascular and Metabolic Medicine, Mariatrosterstr 67, A 8043 Graz, Austria.
authors.forename: Anna-Katharina
authors.initials: AK
authors.lastname: Hanserl
authors.affiliation: RESOURCES - Institute of Water, Energy and Sustainability, Department of Isotope Hydrology and Environmental Analytics, Joanneum Research, Elisabethstraße 16/11, A 8010 Graz, Austria.
authors.forename: Albrecht
authors.initials: A
authors.lastname: Leis
authors.affiliation: Department of Internal Medicine, Krankenhaus Barmherzige Brüder, Marschallgasse 12, A 8020, Graz, Austria.
authors.forename: Herbert
authors.initials: H
authors.lastname: Loibner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D001834:Body Water / Q000378:metabolism*; D016022:Case-Control Studies; D017097:Electric Impedance; D004562:Electrocardiography; D045604:Extracellular Fluid / Q000378:metabolism*; D005260:Female; D006333:Heart Failure / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000033:anatomy & histology*; D009929:Organ Size; D012815:Signal Processing, Computer-Assisted; D055815:Young Adult
keywords: Dry weight; Hydration; Sodium bromide; Whole body DXA