Bioimpedance Spectroscopy Reveals Important Association of Fluid Status and T<sub>1</sub>‐Mapping by Cardiovascular Magnetic Resonance

Donà, Carolina; Nitsche, Christian; Anegg, Oliver; Poschner, Thomas; Koschutnik, Matthias; Duca, Franz; Schneider, Matthias; Schoenbauer, R; Beitzke, Dietrich; Loewe, Christian; Hengstenberg, C; Mascherbauer, Julia; Kammerlander, Andreas A.

doi:10.1002/jmri.27726

Cited by 3 publications

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“…However, poor echocardiographic quality (precluding assessment in approximately one‐fifth of patients in our study) and the lack of standardized sex‐specific and prognostic cut‐off values may limit the broad applicability of vena cava assessment for outcome prediction in AS. In line with the concept of worse cardiac decompensation with higher degrees of congestion, 23 ascending fluid levels were strongly associated with worse outcomes. We observed a 13% increase in the risk of heart failure or death after TAVI with every 1 L increase in fluid levels.…”

Section: Discussionsupporting

confidence: 61%

Quantitative fluid overload in severe aortic stenosis refines cardiac damage and associates with worse outcomes

Halavina,

Koschutnik,

Donà

et al. 2023

European J of Heart Fail

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AimsCardiac decompensation in aortic stenosis (AS) involves extra‐valvular cardiac damage and progressive fluid overload (FO). FO can be objectively quantified using bioimpedance spectroscopy. We aimed to assess the prognostic value of FO beyond established damage markers to guide risk stratification.Methods and resultsConsecutive patients with severe AS scheduled for transcatheter aortic valve implantation (TAVI) underwent prospective risk assessment with bioimpedance spectroscopy (BIS) and echocardiography. FO by BIS was defined as ≥1.0 L (0.0 L = euvolaemia). The extent of cardiac damage was assessed by echocardiography according to an established staging classification. Right‐sided cardiac damage (rCD) was defined as pulmonary vasculature/tricuspid/right ventricular damage. Hospitalization for heart failure (HHF) and/or death served as primary endpoint. In total, 880 patients (81 ± 7 years, 47% female) undergoing TAVI were included and 360 (41%) had FO. Clinical examination in patients with FO was unremarkable for congestion signs in >50%. A quarter had FO but no rCD (FO+/rCD−). FO+/rCD+ had the highest damage markers, including N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) levels. After 2.4 ± 1.0 years of follow‐up, 236 patients (27%) had reached the primary endpoint (29 HHF, 194 deaths, 13 both). Quantitatively, every 1.0 L increase in bioimpedance was associated with a 13% increase in event hazard (adjusted hazard ratio 1.13, 95% confidence interval 1.06–1.22, p < 0.001). FO provided incremental prognostic value to traditional risk markers (NT‐proBNP, EuroSCORE II, damage on echocardiography). Stratification according to FO and rCD yielded worse outcomes for FO+/rCD+ and FO+/rCD−, but not FO−/rCD+, compared to FO−/rCD−.ConclusionQuantitative FO in patients with severe AS improves risk prediction of worse post‐interventional outcomes compared to traditional risk assessment.

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Section: Discussionsupporting

confidence: 61%

Quantitative fluid overload in severe aortic stenosis refines cardiac damage and associates with worse outcomes

Halavina,

Koschutnik,

Donà

et al. 2023

European J of Heart Fail

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“…The edematous status significantly influences the kidney outcomes in CKD patients. Previous studies have employed various markers of fluid status, with many relying on the ECW/TBW and the level of overhydration measured by BIA (29,30). The mechanisms underlying CKD progression caused by excessive body water content have been described, including factors such as the decrease of renal blood flow caused by the increase of renal efferent pressure, glomerular sclerosis, endothelial cell activation, and renal inflammation (31,32).…”

Section: Discussionmentioning

confidence: 99%

Whole-body water mass and kidney function: a Mendelian randomization study

Wei,

Long,

Fan

et al. 2024

Front. Endocrinol.

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BackgroundThe morbidity and mortality of chronic kidney disease (CKD) are increasing worldwide, making it a serious public health problem. Although a potential correlation between body water content and CKD progression has been suggested, the presence of a causal association remains uncertain. This study aimed to determine the causal effect of body water content on kidney function.MethodsGenome-wide association study summary data sourced from UK Biobank were used to evaluate single-nucleotide polymorphisms (SNPs) associated with whole-body water mass (BWM). The summary statistics pertaining to kidney function were extracted from the CKDGen consortium. The primary kidney function outcome measures included estimated glomerular filtration rate (eGFR), albuminuria, CKD stages 3–5, and rapid progression to CKD (CKDi25). Two-sample Mendelian randomization (MR) analysis estimated a potential causal relationship between the BWM and kidney function. The inverse variance weighted MR method was used as the primary analysis, accompanied by several sensitive MR analyses.ResultsThe increase of BWM exhibited a correlation with a reduction in eGFR (β = −0.02; P = 6.95 × 10−16). Excluding 13 SNPs responsible for pleiotropy (P = 0.05), the increase of BWM was also associated with the decrease of the ratio of urinary albumin to creatinine (β = −0.16; P = 5.91 × 10−36). For each standard deviation increase in BWM, the risk of CKD stages 3–5 increases by 32% (OR, 1.32; 95% CI, 1.19–1.47; P = 1.43 × 10−7), and the risk of CKDi25 increases by 22% (OR, 1.22; 95% CI, 1.07–1.38; P = 0.002).ConclusionThe increase of BWM is associated with impaired kidney function. Proactively managing body water content is of great significance in preventing the progression of CKD.

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Thrombus Detection in the Artificial Heart Pump Based on Electrical Impedance Spectroscopy

Li,

Ming,

Wen

et al. 2024

IEEE Sensors J.

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Bioimpedance Spectroscopy Reveals Important Association of Fluid Status and T₁‐Mapping by Cardiovascular Magnetic Resonance

Cited by 3 publications

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Quantitative fluid overload in severe aortic stenosis refines cardiac damage and associates with worse outcomes

Quantitative fluid overload in severe aortic stenosis refines cardiac damage and associates with worse outcomes

Whole-body water mass and kidney function: a Mendelian randomization study

Thrombus Detection in the Artificial Heart Pump Based on Electrical Impedance Spectroscopy

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Bioimpedance Spectroscopy Reveals Important Association of Fluid Status and T1‐Mapping by Cardiovascular Magnetic Resonance

Cited by 3 publications

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Quantitative fluid overload in severe aortic stenosis refines cardiac damage and associates with worse outcomes

Quantitative fluid overload in severe aortic stenosis refines cardiac damage and associates with worse outcomes

Whole-body water mass and kidney function: a Mendelian randomization study

Thrombus Detection in the Artificial Heart Pump Based on Electrical Impedance Spectroscopy

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Bioimpedance Spectroscopy Reveals Important Association of Fluid Status and T₁‐Mapping by Cardiovascular Magnetic Resonance