Abstract
Background: The accuracy of the remote dielectric sensing (ReDSTM) system, which is a noninvasive electromagnetic-based technology to quantify lung fluid levels, particularly among those with small body size, remains uncertain. Methods: Hospitalized patients with and without heart failure underwent assessment of lung fluid levels with ReDS and successive chest computed tomography imaging. We performed a correlation analysis of the ReDS measurement, representing lung fluid levels, and computed tomography-derived high attenuation area percentage, which also provides a spatial quantification of lung fluid level. Results: A total of 46 patients (median 76 years old, 28 men), including 28 patients with heart failure, were included. The median ReDS value was 28% (interquartile: 23%, 33%), and the median percentage of high attenuation area was 21.6% (14.4%, 28.5%). ReDS values and percentage of high attenuation area were moderately correlated (r = 0.65, p < 0.001), irrespective of the existence of heart failure. ReDS value independently predicted the percentage of high attenuation area seen on computed tomography (p < 0.001). Conclusions: The ReDS system may be a promising, noninvasive tool to quantify fluid lung levels, as validated by comparison with chest computed tomography imaging. Further studies are warranted to validate the utility and applicability of this technology to a variety of clinical scenarios.
Highlights
The significant morbidity and mortality benefit of neurohormonal antagonists in patients with chronic heart failure has been shown in large-scale randomized control trials.Comprehensive four-tier medical therapy for chronic heart failure with reduced ejection fraction including angiotensin-neprilysin inhibitors, beta-blockers, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter 2 inhibitors can offer dramatic additional clinical risk reduction compared to angiotensin converting enzyme inhibitors and betablockers alone [1]
Promising data have recently emerged demonstrating the benefit of both angiotensin-neprilysin inhibitors and sodium-glucose cotransporter 2 inhibitors in patients with heart failure and preserved ejection fraction [2,3]
The management of residual pulmonary congestion is an important treatment goal given its impact on patient quality of life [4]
Summary
The significant morbidity and mortality benefit of neurohormonal antagonists in patients with chronic heart failure has been shown in large-scale randomized control trials.Comprehensive four-tier medical therapy for chronic heart failure with reduced ejection fraction including angiotensin-neprilysin inhibitors, beta-blockers, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter 2 inhibitors can offer dramatic additional clinical risk reduction compared to angiotensin converting enzyme inhibitors and betablockers alone [1]. Given the lack of a gold-standard to accurately assess lung fluid levels, precise management of pulmonary. Methods: Hospitalized patients with and without heart failure underwent assessment of lung fluid levels with ReDS and successive chest computed tomography imaging. We performed a correlation analysis of the ReDS measurement, representing lung fluid levels, and computed tomography-derived high attenuation area percentage, which provides a spatial quantification of lung fluid level. 28% (interquartile: 23%, 33%), and the median percentage of high attenuation area was 21.6% (14.4%, 28.5%). ReDS values and percentage of high attenuation area were moderately correlated (r = 0.65, p < 0.001), irrespective of the existence of heart failure. ReDS value independently predicted the percentage of high attenuation area seen on computed tomography (p < 0.001).
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