Abstract
Background: Bioimpedance spectroscopy (BIS) is a non-invasive method used to measure fluid volumes. In this report, we compare BIS measurements from patients with heart failure (HF) to those from healthy adults, and describe how these point-of-care fluid volume assessments may be applied to HF management.Methods and results: Fluid volumes were measured in 64 patients with NYHA class II or III HF and 69 healthy control subjects. BIS parameters including extracellular fluid (ECF), intracellular fluid (ICF), total body water (TBW), and ECF as a percentage of TBW (ECF%TBW) were analyzed. ECF%TBW values for the HF and control populations differed significantly (49.2 ± 3.2% vs. 45.2 ± 2.1%, respectively; p < 0.001); both distributions satisfied criteria for normality. Interquartile ranges did not overlap (46.7–51.0% vs. 43.8–46.4%, respectively; p < 0.001). Subgroup analyses of HF patients who underwent transthoracic echocardiography showed that impedance measurements correlated with inferior vena cava size (Pearson correlation −0.73, p < 0.0001). A case study is presented for illustrative purposes.Conclusions: BIS-measured ECF%TBW values were significantly higher in HF patients as compared to adults without HF. We describe three strata of ECF%TBW (normal, elevated, fluid overload) that may aid in clinical risk stratification and fluid volume monitoring of HF patients.Clinical Trial Registration: COMPARE – www.ClinicalTrials.gov; IMPEL – www.ClinicalTrials.gov; Heart Failure at Home – www.ClinicalTrials.gov, identifier: NCT02939053; NCT02857231; NCT04013373.
Highlights
Heart failure (HF) affects ∼26 million people worldwide, with the prevalence increasing as the population ages [1]
Potential subjects were excluded if they were pregnant, breast feeding, or had other comorbidities that could result in fluid overload; namely, renal failure, nephrotic syndrome or nephrosis, lymphedema, chronic liver failure or cirrhosis, and thrombophlebitis or deep vein thrombosis of the extremities
In the present report, based on measurements from HF and healthy control populations, we describe three strata of bioimpedance spectroscopy (BIS)-measured extracellular fluid (ECF)%total body water (TBW) (Figure 3B) that may contribute to clinical risk stratification and may serve as a tool to help facilitate future outcomes research
Summary
Heart failure (HF) affects ∼26 million people worldwide, with the prevalence increasing as the population ages [1]. In the United States alone, HF affects an estimated 6.2 million individuals [2]. This condition places a substantial burden on health care systems with high rates of hospitalizations, readmissions, and outpatient visits. Up to 25% of HF patients are readmitted within 30 days [4, 5]. Bioimpedance spectroscopy (BIS) is a non-invasive method used to measure fluid volumes. We compare BIS measurements from patients with heart failure (HF) to those from healthy adults, and describe how these point-of-care fluid volume assessments may be applied to HF management
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