Dataset Information

Home Bioelectrical Impedance Analysis Management System in Patients With Heart Failure: Rationale and Study Design.

ABSTRACT: Body fluid monitoring and management are essential to control dyspnea and prevent re-hospitalization in patients with chronic heart failure (HF). There are several methods to estimate and monitor patient's volume status, such as symptoms, signs, body weight, and implantable devices. However, these methods might be difficult to use for reasons that are slow to reflect body water change, inaccurate in specific patients' condition, or invasive. Bioelectrical impedance analysis (BIA) is a novel method for body water monitoring in patients with HF, and the value in prognosis has been proven in previous studies. We aim to determine the efficacy and safety of home BIA body water monitoring-guided HF treatment in patients with chronic HF. This multi-center, open-label, randomized control trial will enroll patients with HF who are taking loop diuretics. The home BIA group patients will be monitored for body water using a home BIA device and receive messages regarding their edema status and direction of additional diuretics usage or behavioral changes through the linked application system once weekly. The control group patients will receive the usual HF management. The primary endpoint is the change in N-terminal prohormone of brain natriuretic peptide levels from baseline after 12 weeks. This trial will provide crucial evidence for patient management with a novel home BIA body water monitoring system in patients with HF.

SUBMITTER: Kong MG

PROVIDER: S-EPMC10827698 | biostudies-literature | 2024 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Home Bioelectrical Impedance Analysis Management System in Patients With Heart Failure: Rationale and Study Design.

Kong Min Gyu MG Moon Inki I Seo Hye-Sun HS Suh Jon J Choi Jah Yeon JY Na Jin Oh JO Kim Eung Ju EJ

International journal of heart failure 20230829 1

Body fluid monitoring and management are essential to control dyspnea and prevent re-hospitalization in patients with chronic heart failure (HF). There are several methods to estimate and monitor patient's volume status, such as symptoms, signs, body weight, and implantable devices. However, these methods might be difficult to use for reasons that are slow to reflect body water change, inaccurate in specific patients' condition, or invasive. Bioelectrical impedance analysis (BIA) is a novel meth ...[more]

PMID: 38303915

Similar Datasets

Project description:BackgroundThe phase angle (PhA) in bioelectrical impedance analysis (BIA) reflects the cell membrane integrity or body fluid equilibrium. We examined how the PhA aligns with previously known markers of acute heart failure (HF) and assessed its value as a screening tool.MethodsPhA was measured in 50 patients with HF and 20 non-HF controls along with the edema index (EI), another BIA parameter suggestive of edema. Chest computed tomography-measured lung fluid content (LFC) was used to assess pulmonary congestion. A correlation analysis was conducted to evaluate the relationships between PhA and EI, NT-proBNP, and LFC. Receiver operating characteristic (ROC) curve analysis was used to determine the cut-off values for PhA and EI for classifying patients with HF. The area under the curve (AUC) was compared using the DeLong test to evaluate the performance of PhA and EI compared to that of LFC in correctly classifying HF.ResultsThe PhA levels were significantly lower in the HF group. Whole-body PhA was 4.49° in the HF group and 5.68° in the control group. Moderate and significant correlation was observed between PhA measured at 50-kHz and both NT-proBNP (-0.56 to -0.27, all p-values<0.05) and LFC (-0.52 to -0.41, all p-values <0.05). The AUC for whole-body PhA was 0.827 (confidence interval [CI] 0.724-0.931, p<0.01) and was 0.883 (CI 0.806-0.961, p<0.01) for EI, and the optimal cutoffs were estimated as 5° (sensitivity 0.84, specificity 0.80) and 0.394 (sensitivity 0.78, specificity 0.95), respectively. When both PhA and EI were included in the model, the AUC increased to 0.905, and this was comparable to that of LFC (AUC = 0.913, p = 0.857).ConclusionsPhA exhibited a correlation with known markers of HF and demonstrated its potential as a non-invasive screening tool for the early detection of HF exacerbation. The combined use of PhA and EI can provide a robust alternative for routine self-monitoring in patients with HF, thereby enhancing early intervention.

Project description:Background Volume overload is associated not only with clinical manifestations but also with poor outcomes of heart failure (HF). However, there is an unmet need for effective methods for serial monitoring of volume status during HF hospitalization. The aim of this study was to evaluate the prognostic implication of serial measurement of bioelectrical impedance analysis (BIA) in patients hospitalized with acute HF. Methods This study is a retrospective observational study and screened 310 patients hospitalized due to acute decompensated HF between November 2021 and September 2022. Among them, 116 patients with acute HF who underwent BIA at the time of admission and at discharge were evaluated. We investigated the correlation between change of BIA parameters and the primary composite outcome (in-hospital mortality or rehospitalization for worsening HF within one month). Results The median (interquartile range) age was 77 years (67–82 years). The mean left ventricular ejection fraction was 40.7 ± 14.6% and 55.8% of HF patients have HF with reduced ejection fraction. The body water composition (intracellular water [ICW], extracellular water [ECW], and total body water [TBW]) showed a statistically significant correlation with body mass index and LV chamber sizes. Furthermore, the ratio of ECW to TBW (ECW/TBW), as an edema index showed a significant correlation with natriuretic peptide levels. Notably, the change of the edema index during hospitalization (ΔECW/TBW) showed a significant correlation with the primary outcome. The area under the curve of ΔECW/TBW for predicting primary outcome was 0.71 (95% confidence interval [CI], 0.61–0.79; P = 0.006). When patients were divided into two groups based on the median value of ΔECW/TBW, the group of high and positive ΔECW/TBW (+0.3% to +5.1%) had a significantly higher risk of the primary outcome (23.2% vs. 8.3%, adjusted odds ratio, 4.8; 95% CI, 1.2–19.3; P = 0.029) than those with a low and negative ΔECW/TBW (−5.3% to +0.2%). Conclusion BIA is a noninvasive and effective method to evaluate the volume status during the hospitalization of HF patients. The high and positive value of ΔECW/TBW during hospitalization was associated with poor outcomes in patients with HF. Graphical Abstract

Dataset Information

Home Bioelectrical Impedance Analysis Management System in Patients With Heart Failure: Rationale and Study Design.

Publications

Home Bioelectrical Impedance Analysis Management System in Patients With Heart Failure: Rationale and Study Design.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets