Noninvasive Bioimpedance Methods From the Viewpoint of Remote Monitoring in Heart Failure

Pawel Krzesinski,Piotr Murawski,Aleksander Sobotnicki,Grzegorz Gielerak,Janusz Siebert,Andrzej Walczak,Adam Gacek

doi:10.2196/25937

Abstract

Heart failure (HF) is a major clinical, social, and economic problem. In view of the important role of fluid overload in the pathogenesis of HF exacerbation, early detection of fluid retention is of key importance in preventing emergency admissions for this reason. However, tools for monitoring volume status that could be widely used in the home setting are still missing. The physical properties of human tissues allow for the use of impedance-based noninvasive methods, whose different modifications are studied in patients with HF for the assessment of body hydration. The aim of this paper is to present the current state of knowledge on the possible applications of these methods for remote (home-based) monitoring of patients with HF.

Highlights

Heart failure (HF) is a major clinical, social, and economic problem, which is attributable, among other factors, to the high frequency of exacerbations requiring urgent hospital admission
The aim of this paper is to present the current state of knowledge on the possible applications of these methods for remote monitoring of patients with HF
A prospective, open-label, single-center study was conducted in a group of 222 patients with HF and left ventricular ejection fraction (LVEF) less than 35%, who were hospitalized within 12 months of recruitment with HF exacerbation [19]

Summary

Introduction

Heart failure (HF) is a major clinical, social, and economic problem, which is attributable, among other factors, to the high frequency of exacerbations requiring urgent hospital admission. In view of the important role of fluid overload in the pathogenesis of HF exacerbation, early detection of fluid retention is of key importance for preventing emergency admissions This is theoretically possible, as there is a time window of 10 to 20 days between the onset of fluid overload and hospital admission due to decompensated HF [4]. The complexity of the pathophysiological processes involved in fluid retention and redistribution hinders the possibility of predicting exacerbation episodes with adequate sensitivity and specificity based solely on body weight monitoring [5] This is desirable for the assessment of the overall fluid status, and fluid levels in different body compartments, with a particular focus on the chest. The possible assessment of hemodynamic parameters, such as heart rate, stroke volume (SV), and cardiac output (CO), has important added value in the assessment of the etiology of cardiovascular decompensation

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