Nocturnal thoracic volume overload and post‐discharge outcomes in patients hospitalized for acute heart failure

Chang, Hong‐Tai; Huang, Chin Chou; Cheng, Hao Min; Yu, Wen Chung; Chiang, Chern En; Sung, Shih Hsien

doi:10.1002/ehf2.12881

Cited by 3 publications

(1 citation statement)

References 33 publications

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“…Our findings support this theory, as we observed higher ReDS values in both the night and early morning measurements. Consistently, using another modality impedance cardiography, nocturnal whole thoracic volume overload, instead of pulmonary congestion, was recently observed [ 11 ].…”

Section: Discussionsupporting

confidence: 69%

Chronotype of Lung Fluid Levels in Patients with Chronic Heart Failure

Ueno

Imamura

Narang

et al. 2022

JCM

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Background: The variation in lung fluid levels dependent on chronotype in patients with chronic heart failure is unclear. Remote dielectric sensing (ReDSTM) is a novel non-invasive system to quantify the lung fluids, which may correlate to intracardiac filling pressures. We aimed to understand the variation in ReDS measurements by chronotype in patients with chronic heart failure. Methods: The patients who were hospitalized for heart failure exacerbations between November 2021 and March 2022 were prospectively included. ReDS values were measured at clinically stable conditions at the following three time points during the day: 5:00 (morning), 12:00 (noon), and 21:00 (night) (manufacture-recommended reference of ReDS value: between 25% and 35%). Results: Twelve patients were included. The median age was 84 (75, 90) years and four patients (33%) were men. The median plasma B-type natriuretic peptide was 235 (178, 450) pg/mL. The median ReDS value was 38% (23%, 41%) in the morning. The ReDS value decreased significantly at the noon measurement, down to 28% (23%, 29%) (p = 0.005) and again increased significantly at the night measurement, up to 31% (27%, 42%) (p = 0.002). The patients were clinically stabilized during the observational period. Conclusions: the lung fluid level varied considerably in patients with chronic heart failure following clinical stabilization.

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Section: Discussionsupporting

confidence: 69%

Chronotype of Lung Fluid Levels in Patients with Chronic Heart Failure

Ueno

Imamura

Narang

et al. 2022

JCM

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The role of cardiac acoustic biomarkers in monitoring patients with heart failure: A systematic literature review

Butler,

Brown,

Prokocimer

et al. 2024

ESC Heart Failure

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Heart failure (HF) creates a considerable clinical, humanistic and economic burden on patients and caregivers as well as on healthcare systems. To attenuate the significant burden of HF, there is a need for enhanced management of patients with HF. The use of digital tools for remote non‐invasive monitoring of heart parameters is gaining traction, and cardiac acoustic biomarkers (CABs) have been proposed as a complementary set of measures to assess heart function alongside traditional methods such as electrocardiogram and echocardiography. We conducted a systematic literature review to evaluate associations between CABs and HF outcomes. Embase and MEDLINE databases were searched for recent studies published between 2013 and 2023 that evaluated CABs in patients with HF. Additional grey literature (i.e., conference, congress and pre‐print publications from January 2021 to May 2023) searches were included. Two reviewers independently examined all articles; a third resolved conflicts. Data were extracted from articles meeting inclusion criteria. Extracted studies underwent quality and bias assessments using the Joanna Briggs Institute (JBI) critical appraisal tools. In total, 3074 records were screened, 73 full‐text articles were assessed for eligibility and 27 publications were included. Third heart sound (S3) and electromechanical activation time (EMAT) were the CABs most often reported in the literature for monitoring HF. Fifteen publications discussed changes in S3 characteristics and its role in HF detection or outcomes: six studies highlighted S3 assessment among various groups of patients with HF; four studies evaluated the strength or amplitude of S3 with clinical outcomes; five studies assessed the relationship between S3 presence and clinical outcomes; and one study assessed both S3 presence and amplitude in relation to HF clinical outcomes. Eleven publications reported on EMAT and its derivatives: five studies on the relationship between EMAT and HF and six studies on the association of EMAT and HF clinical outcomes. Studies reporting the first and fourth heart sound, left ventricular ejection time and systolic dysfunction index were limited. Published literature supported S3 and EMAT as robust CAB measures in HF that may have value in remote clinical monitoring and management of patients with HF. Additional studies designed to test the predictive power of these CABs, and others less well‐characterized, are needed. This work was funded by Astellas Pharma Inc.

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The prognostic value of systemic vascular resistance in heart failure patients with permanent atrial fibrillation: a retrospective study

Jing,

Zhang,

Ding

et al. 2023

Heart Vessels

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Heart failure (HF) and permanent atrial fibrillation (AF) interact mutually, exacerbating hemodynamic effects and causing adverse outcomes and increased healthcare costs. Monitoring hemodynamic indicators in patients with these comorbidities is crucial for effective clinical management. Transthoracic impedance cardiography (ICG) has been widely employed in assessing hemodynamic status in clinical settings. Given the limited research on the prognostic significance of ICG parameters in HF with permanent AF, we undertook this study. A total of 66 HF patients with permanent AF were included in this retrospective study, and the primary outcome was rehospitalization due to worsening HF within 180-day post-discharge. Cox regression analysis was performed to explore the connection between ICG-evaluated parameters and the outcome risk. Receiver operating characteristic (ROC) curve analysis determined the optimal cutoff values of risk factors, subsequently applied in plotting Kaplan Meier (KM) survival curves. Multivariate Cox regression analysis revealed that systemic vascular resistance (SVR) both on admission and at discharge independently predicted rehospitalization for worsening HF. ROC analysis established optimal SVR cutoff values: 320.89 (kPa s/L) on admission and 169.94 (kPa s/L) at discharge (sensitivity 70%, specificity 94.4%, area under the curve (AUC) 0.831, respectively, sensitivity 90%, specificity 55.6%, AUC 0.742). KM survival curves analysis showed that patients with SVR > 320.89 (kPa s/L) on admission had an 8.14-fold (P < 0.001) increased risk of the end-point event compared with those with SVR ≤ 320.89 (kPa s/L). Similarly, patients with SVR > 169.94 (kPa s/L) at discharge faced a risk elevated by 6.57 times (P = 0.002) relative to those with SVR ≤ 169.94 (kPa s/L). In HF patients with permanent AF, SVR measured by ICG emerges as an independent risk factor and clinical predictor for HF deterioration-related readmission within 180 days after discharge. Higher SVR levels, both upon admission and at discharge, correlate with an incremental rehospitalization risk.

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Nocturnal thoracic volume overload and post‐discharge outcomes in patients hospitalized for acute heart failure

Cited by 3 publications

References 33 publications

Chronotype of Lung Fluid Levels in Patients with Chronic Heart Failure

Chronotype of Lung Fluid Levels in Patients with Chronic Heart Failure

The role of cardiac acoustic biomarkers in monitoring patients with heart failure: A systematic literature review

The prognostic value of systemic vascular resistance in heart failure patients with permanent atrial fibrillation: a retrospective study

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