Bedside use of thoracic bioimpedance to document and monitor heart failure with preserved systolic function: Delineation of impaired stroke volume reserve

Cianci, Pamela; Lonergan-Thomas, Helen; Brennan, Sharon L.; Silver, Marc A.

doi:10.1016/s1071-9164(03)00349-x

Cited by 3 publications

(4 citation statements)

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“…Our study showed low values of cardiac pump function parameters (SI and CI) in AC patients, even despite well-controlled AH; this corresponded with echocardiographic evidence of abnormal LV function. Studies in other populations of patients with HF and essential AH have demonstrated a correlation between the values of ICG-assessed hemodynamic parameters and those of echocardiographic indices of LV function ( 17 – 19 , 45 , 46 ).…”

Section: Discussionmentioning

confidence: 95%

Acromegaly: The Research and Practical Value of Noninvasive Hemodynamic Assessments via Impedance Cardiography

et al. 2022

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BackgroundArterial hypertension (AH) that accompanies acromegaly (AC) may lead to cardiovascular dysfunction. Such consequences may be detected with impedance cardiography (ICG), which is a noninvasive method of hemodynamic assessment. Early detection of subclinical hemodynamic alterations in AC patients may be crucial for optimizing treatment and preventing cardiovascular remodeling. The purpose of this study was to identify the hemodynamic parameters of the cardiovascular system that differentiate patients with AC from those in the control group (CG), with a particular emphasis on potential targets for medical therapy.MethodsThis observational, prospective, clinical study involved a comparative analysis of 33 AC patients with no significant comorbidities and the controls selected via propensity score matching based on a set of baseline characteristics (age, sex, body mass index, mean blood pressure [MBP]), with comparable proportions of AH patients. The assessed hemodynamic parameters included the stroke volume index (SI), cardiac index, systemic vascular resistance index, velocity index (VI), acceleration index, Heather index (HI), and thoracic fluid content (TFC).ResultsBoth the AC group and the CG had well-controlled AH (mean blood pressure of 121/77 mmHg and 119/76 mmHg, respectively). In terms of baseline characteristics, the AC group was characterized by a higher hear rate and lower creatinine levels than the CG (76.2 bpm vs. 66.8 bpm [p = 0.001] and 0.755 mg/dL vs. 0.850 mg/dL [p = 0.035], respectively). ICG assessment of AC patients and CG patients showed the former to have higher heart rates (73.5 bpm vs. 65.2 bpm; p = 0.003), lower SI (43.8 mL/m2 vs. 53.4 mL/m2; p = 0.0001), lower VI (42.1 1/1000/s vs. 49.3 1/1000/s; p = 0.037), lower HI (8.49 Ohm/s2 vs. 13.4 Ohm/s2, p ≤ 0.0001), and higher thoracic fluid content (TFC) (38.4 1/kOhm vs. 28.1 1/kOhm; p ≤ 0.0001), respectively.ConclusionsEven with well-controlled hypertension, AC is associated with a high TFC, increased heart rate, and decreased indices of cardiac contractility. Hemodynamic changes in AC patients may be detected with the modern, noninvasive diagnostic tool, ICG.

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Section: Discussionmentioning

confidence: 95%

Acromegaly: The Research and Practical Value of Noninvasive Hemodynamic Assessments via Impedance Cardiography

et al. 2022

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“…A study in patients with heart failure showed a significant correlation between changes in the cardiac index value determined via impedance cardiography and the left ventricular ejection fraction measured echocardiographically (11). Moreover, a hemodynamic assessment was reported to be of clinical significance in patients with heart failure with preserved left ventricular systolic function (42). There was also a significant correlation between impaired left ventricular systolic function and low values of parameters characterizing blood flow, such as velocity index and acceleration index (43).…”

Section: Discussionmentioning

confidence: 99%

Cushing’s Disease: Assessment of Early Cardiovascular Hemodynamic Dysfunction With Impedance Cardiography

et al. 2021

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BackgroundCushing’s disease is a rare condition associated with a high cardiovascular risk and hypercortisolemia-related hemodynamic dysfunction, the extent of which can be assessed with a noninvasive method, called impedance cardiography. The standard methods for hemodynamic assessment, such as echocardiography or ambulatory blood pressure monitoring may be insufficient to fully evaluate patients with Cushing’s disease; therefore, impedance cardiography is being currently considered a new modality for assessing early hemodynamic dysfunction in this patient population. The use of impedance cardiography for diagnosis and treatment of Cushing’s disease may serve as personalized noninvasive hemodynamic status assessment and provide a better insight into the pathophysiology of Cushing’s disease. The purpose of this study was to assess the hemodynamic profile of Cushing’s disease patients and compare it with that in the control group.Material and MethodsThis observational prospective clinical study aimed to compare 54 patients with Cushing’s disease (mean age 41 years; with 64.8% of this population affected with arterial hypertension) and a matched 54-person control group (mean age 45 years; with 74.1% of this population affected with arterial hypertension). The hemodynamic parameters assessed with impedance cardiography included the stroke index (SI), cardiac index (CI), systemic vascular resistance index (SVRI), velocity index (VI), (ACI), Heather index (HI), and thoracic fluid content (TFC).ResultsThe Cushing’s disease group was characterized by a higher diastolic blood pressure and a younger age than the control group (82.9 vs. 79.1 mmHg, p=0.045; and 41.1 vs. 44.9 years, p=0.035, respectively). Impedance cardiography parameters in the Cushing’s disease group showed: lower values of SI (42.1 vs. 52.8 ml/m2; p ≤ 0.0001), CI (2.99 vs. 3.64 l/min/m2; p ≤ 0,0001), VI (42.9 vs. 52.1 1/1000/s; p=0.001), ACI (68.7 vs. 80.5 1/100/s2; p=0,037), HI (13.1 vs. 15.2 Ohm/s2; p=0.033), and TFC (25.5 vs. 27.7 1/kOhm; p=0.006) and a higher SVRI (2,515 vs. 1,893 dyn*s*cm-5*m2; p ≤ 0.0001) than those in the control group.ConclusionsCushing’s disease is associated with significantly greater vasoconstriction and left ventricular systolic dysfunction. An individual assessment with impedance cardiography may be useful in Cushing’s disease patients in order to identify subclinical cardiovascular complications of chronic hypercortisolemia as potential therapeutic targets.

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“…In previous studies, ICG hemodynamic parameters have shown diagnostic value in determination of cardiac vs. noncardiac causes of emergent dyspnea, 33 profiling of emergent HF vs. non‐HF, 34 and determination of systolic dysfunction vs. preserved systolic function 35,36 . Prognostic value has been shown in advanced HF in profiling survivors vs. nonsurvivors 37 and in association with need for hospitalization 38 .…”

Section: Discussionmentioning

confidence: 99%

“…31,32 In previous studies, ICG hemodynamic parameters have shown diagnostic value in determination of cardiac vs. noncardiac causes of emergent dyspnea, 33 profiling of emergent HF vs. non-HF, 34 and determination of systolic dysfunction vs. preserved systolic function. 35,36 Prognostic value has been shown in advanced HF in profiling survivors vs. nonsurvivors 37 and in association with need for hospitalization. 38 ICG has demonstrated value in therapeutic management with pacemaker optimization, 39 β blocker titration, 40 and in documenting hemodynamic stability and improvement with intravenous nesiritide administration.…”

Section: Discussionmentioning

confidence: 99%

Association of Impedance Cardiography Parameters With Changes in Functional and Quality‐of‐Life Measures in Patients With Chronic Heart Failure

Vijayaraghavan

Crum

Cherukuri

et al. 2004

Congestive Heart Failure

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Assessment and prognosis of chronic heart failure is often difficult due to a lack of objective and easily obtainable parameters that accurately reflect disease status. This study was conducted to determine whether impedance cardiography (ICG) parameters were associated with changes in functional and quality-of-life measures in chronic heart failure patients. Retrospective chart review identified 64 patients (73% male, aged 73+/-13 years) with paired ICG measurements followed for 180+113 days. Outcome measures were changes in New York Heart Association class, 6-minute walk distance, patient visual analog scale score, and Minnesota Living with Heart Failure Questionnaire score. Measures of ICG, heart rate and blood pressure, left ventricular ejection fraction, and B-type natriuretic peptide levels were assessed for their association with outcome measures. From baseline to final evaluation, there were significant changes (p<0.05) in New York Heart Association class (from 3.2+/-0.5 to 3.0+/-0.6), 6-minute walk distance (from 668+/-380 m to 874+/-390 m), patient visual analog scale score (from 49+/-10 to 64+/-20), Minnesota Living with Heart Failure Questionnaire score (from 54+/-22 to 39+/-22), and ICG parameters of stroke index (from 38+/-9 to 41+/-8), left ventricular ejection time (from 273+/-42 to 291+/-33), and systolic time ratio (from 0.56+/-0.2 to 0.52+/-0.2). Changes in multivariate ICG parameters were significantly correlated to changes in New York Heart Association class (R, 0.80), 6-minute walk distance (R, 0.94), patient visual analog scale score (R, 0.69), and Minnesota Living with Heart Failure Questionnaire score (R, 0.67). ICG provides objective data that reflects changes in chronic heart failure disease status and treatment effectiveness.

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Bedside use of thoracic bioimpedance to document and monitor heart failure with preserved systolic function: Delineation of impaired stroke volume reserve

Cited by 3 publications

References 0 publications

Acromegaly: The Research and Practical Value of Noninvasive Hemodynamic Assessments via Impedance Cardiography

Acromegaly: The Research and Practical Value of Noninvasive Hemodynamic Assessments via Impedance Cardiography

Cushing’s Disease: Assessment of Early Cardiovascular Hemodynamic Dysfunction With Impedance Cardiography

Association of Impedance Cardiography Parameters With Changes in Functional and Quality‐of‐Life Measures in Patients With Chronic Heart Failure

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