Abstract
Introduction.Diagnostics of congestive events in chronic heart failure (CHF) in elderly people is increasingly relevant due to the general aging of the population, which determines the search for new research methods.The aimis to evaluate the diagnostic capabilities of bioimpedance method in determining the severity of congestion in elderly patients with CHF.Materials and methods.86 elderly patients with CHF of different clinical stages were examined, 36.0% of them were burdened with varicose vein disease of the lower limbs. Total body water content was assessed by active impedance at 50 kHz, extracellular fluid content — at 5 kHz.Results.Active resistance at 50 kHz in patients with CHF II B was 473.92±29.39, with CHF II A - 569.24±58.97, with CHF I — 601.33±24.64 ohms, respectively, at 5 kHz — 555.52±27.44, 633.50±51.32 and 722.50±15.85 ohms respectively. No total and/or extracellular fluid retention was detected in CHF II A without lower limb varicosity, and in 10 (58.8%) patients — in cases of its presence. Retention of total and/or extracellular fluid was detected in 74.4% of CHF stage II B patients, and 48.3% of them had varicose vein disease of the lower limbs.Discussion.Patients with CHF stage II B have the highest amount of total and extracellular fluid in the body compared to patients with CHF stage II A and CHF stage I, but the method is insensitive for diagnosis of fluid retention in the small circle of the circulation and differential diagnosis of the genesis of edema in varicose vein disease of the lower limbs.Conclusion.Bioimpedance imaging can be used for additional diagnostics of CHF in elderly patients in order to estimate the amount of total/extracellular fluid in the body to build personalized treatment and prevention programs.
Highlights
Diagnostics of congestive events in chronic heart failure (CHF) in elderly people is increasingly relevant due to the general aging of the population, which determines the search for new research methods
Materials and methods. 86 elderly patients with CHF of different clinical stages were examined, 36.0% of them were burdened with varicose vein disease of the lower limbs
Retention of total and/or extracellular fluid was detected in 74.4% of CHF stage II B patients, and 48.3% of them had varicose vein disease of the lower limbs
Summary
Diagnostics of congestive events in chronic heart failure (CHF) in elderly people is increasingly relevant due to the general aging of the population, which determines the search for new research methods. С помощью ROC-анализа была проверена достоверность модели диагностики задержки общей и/или внеклеточной жидкости в организме пациентов с ХСН II А и II Б стадий биоимпедансным методом всего тела при наличии или же отсутствии ВБВНК. Пациенты с застоем по малому кругу кровообращения с ХСН II А стадии, не страдавшие ВБВНК (n=18), не имели признаков задержки общей и/ или внеклеточной жидкости при проведении им биоимпедансометрии, тогда как при наличии ВБВНК (n=17) у 10 (58,8%) пациентов была обнаружена избыточная жидкость в организме. Проверка качества модели диагностики задержки общей и/или внеклеточной жидкости в организме пациентов с ХСН II А и II Б стадий, имеющих и не имеющих ВБВНК, биоимпедансным методом всего тела с помощью ROC-анализа в нашей работе не была показательной. Это свидетельствует о нечувствительности использованного биоимпедансного метода исследования при выявлении задержки жидкости в малом круге кровообращения у пациентов пожилого возраста с ХСН без сопутствующего застоя в большом круге. Средние показатели при разных стадиях ХСН ХСН I (n=12) ХСН II А (n=35) ХСН II Б (n=39)
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