PMID- 22813787
OWN - NLM
STAT- MEDLINE
DCOM- 20130325
LR  - 20190819
IS  - 1347-4820 (Electronic)
IS  - 1346-9843 (Linking)
VI  - 76
IP  - 11
DP  - 2012
TI  - Intrathoracic impedance monitoring in patients with heart failure: correlation 
      with dehydration and bleeding events.
PG  - 2592-8
AB  - BACKGROUND: Cardiac resynchronization therapy/defibrillators (CRTD) and 
      implantable cardioverter defibrillators (ICD) with continuous intrathoracic 
      impedance monitoring might provide an early warning of thoracic fluid retention. 
      In contrast, volume loss events such as dehydration and bleeding are also common 
      events in heart failure patients treated with diuretics and anticoagulants. The 
      correlation between intrathoracic impedance and a volume loss event is not known. 
      METHODS AND RESULTS: This study evaluated the association between intrathoracic 
      impedance and volume loss events in 36 patients with chronic heart failure (New 
      York Heart Association [NYHA] II, III and IV) who had received CRTD/ICD 
      implantation. Elevation of thoracic impedance above the reference line was 
      defined as a positive deviation of thoracic impedance (PDI). This study recorded 
      249 PDIs including 60 spike PDIs defined as over 5 ohms elevation from the 
      reference line and 17 large PDIs as over 5 ohms elevation and continuing for at 
      least 4 days. Clinically, 96 dehydration events and 2 bleeding events were 
      observed over a 1-year period. The sensitivity and positive predictive value 
      (PPV) for spike PDI was 31.6% and 51.7%, respectively, while those for large PDI 
      were 17.3% and 100%, respectively. CONCLUSIONS: A large PDI reflected dehydration 
      and bleeding events with a high PPV in severe heart failure patients. The large 
      PDI criteria might therefore be useful for predicting volume loss events in 
      chronic heart failure patients.
FAU - Asada, Kazuo
AU  - Asada K
AD  - Department of Cardiovascular Medicine, University of Tokyo Graduate School of 
      Medicine, Tokyo, Japan.
FAU - Fujiu, Katsuhito
AU  - Fujiu K
FAU - Imai, Yasushi
AU  - Imai Y
FAU - Kojima, Toshiya
AU  - Kojima T
FAU - Sugiyama, Hiroaki
AU  - Sugiyama H
FAU - Suzuki, Takeki
AU  - Suzuki T
FAU - Kinugawa, Koichiro
AU  - Kinugawa K
FAU - Hirata, Yasunobu
AU  - Hirata Y
FAU - Nagai, Ryozo
AU  - Nagai R
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120714
PL  - Japan
TA  - Circ J
JT  - Circulation journal : official journal of the Japanese Circulation Society
JID - 101137683
SB  - IM
CIN - Circ J. 2012;76(11):2538-9. PMID: 23047257
MH  - Adult
MH  - Aged
MH  - *Cardiac Resynchronization Therapy
MH  - Cardiography, Impedance/methods
MH  - Chronic Disease
MH  - *Defibrillators, Implantable
MH  - Dehydration/etiology/*physiopathology
MH  - Female
MH  - Heart Failure/complications/*physiopathology/*therapy
MH  - Hemorrhage/etiology/*physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
EDAT- 2012/07/21 06:00
MHDA- 2013/03/26 06:00
CRDT- 2012/07/21 06:00
PHST- 2012/07/21 06:00 [entrez]
PHST- 2012/07/21 06:00 [pubmed]
PHST- 2013/03/26 06:00 [medline]
AID - DN/JST.JSTAGE/circj/CJ-12-0187 [pii]
AID - 10.1253/circj.cj-12-0187 [doi]
PST - ppublish
SO  - Circ J. 2012;76(11):2592-8. doi: 10.1253/circj.cj-12-0187. Epub 2012 Jul 14.