PMID- 27175605
OWN - NLM
STAT- MEDLINE
DCOM- 20170327
LR  - 20220317
IS  - 1932-8737 (Electronic)
IS  - 0160-9289 (Print)
IS  - 0160-9289 (Linking)
VI  - 39
IP  - 8
DP  - 2016 Aug
TI  - Monitoring of Daily Body Weight and Intrathoracic Impedance in Heart Failure 
      Patients With a High Risk of Volume Overload Decompensation.
PG  - 446-52
LID - 10.1002/clc.22547 [doi]
AB  - BACKGROUND: Decompensation is frequent in heart failure (HF) patients and 
      predicts poor prognosis. HYPOTHESIS: Volume-overload events in HF patients are 
      preceded by changes in intrathoracic impedance (Z) and body weight (BW); 
      monitoring these parameters may be useful to predict decompensation. METHODS: 
      Forty-three HF patients (LVEF 25% +/- 12%) with a recent HF event and an 
      implantable cardioverter-defibrillator providing daily Z were equipped with 
      telemonitoring scales submitting daily BW. Changes in BW and Z 30 days prior to 
      major (HF hospitalization) and minor (ambulatory adjustment of diuretics) were 
      analyzed. RESULTS: During median of 427 days follow-up 25 major and 41 minor 
      events occurred. Z decreased by -4.8 (95% confidence interval [CI]: CI -6.7 to 
      -3.0) and -4.3 (95% CI: -5.5 to -3.2) within 30 days prior to major and minor 
      events respectively (P < 0.001). BW increased before major events by 2.3 kg (95% 
      CI: 1.0 to 3.5, P < 0.01) and minor events 1 kg (95% CI: 0.5 to 1.4, P < 0.001). 
      Sensitivity of Z for major/minor HF events was 83.3% (95% CI: 71.7 to 91.0) and 
      for BW 43.9% (95% CI: 31.9 to 56.7). The unexplained detection rate per 
      patient-year was 1.6 (interquartile range [IQR], 0-3.1) for Z and 4.8 (IQR 
      1.6-11.1) for BW. Combined Z and BW sensitivity was 42.4% (95% CI: 30.6 to 55.2) 
      and unexplained detection rate was 0.8 (IQR, 0-1.5) per patient-year. 
      CONCLUSIONS: Decompensation is marked by a decrease in Z and increase in BW the 
      preceding 30 days. Monitoring of Z predicts HF decompensations with better 
      sensitivity and lower unexplained detection rate than BW.
CI  - (c) 2016 Wiley Periodicals, Inc.
FAU - Gudmundsson, Kristjan
AU  - Gudmundsson K
AD  - Karolinska Institute, Department of Cardiology, Karolinska University Hospital, 
      Stockholm, Sweden.
FAU - Lynga, Patrik
AU  - Lynga P
AD  - Department of Clinical Science and Education (Lynga), Stockholm South General 
      Hospital, Stockholm, Sweden.
FAU - Rosenqvist, Marten
AU  - Rosenqvist M
AD  - Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden.
FAU - Braunschweig, Frieder
AU  - Braunschweig F
AD  - Karolinska Institute, Department of Cardiology, Karolinska University Hospital, 
      Stockholm, Sweden.
LA  - eng
PT  - Journal Article
DEP - 20160513
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
RN  - 0 (Diuretics)
SB  - IM
MH  - Aged
MH  - Cardiac Resynchronization Therapy
MH  - Cardiac Resynchronization Therapy Devices
MH  - *Cardiography, Impedance/instrumentation
MH  - Defibrillators, Implantable
MH  - Diuretics/therapeutic use
MH  - Electric Countershock/instrumentation
MH  - Female
MH  - Heart Failure/*diagnosis/physiopathology/therapy
MH  - *Hemodynamics
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Registries
MH  - Reproducibility of Results
MH  - Stroke Volume
MH  - Sweden
MH  - *Telemetry/instrumentation
MH  - Time Factors
MH  - Treatment Outcome
MH  - Ventricular Function, Left
MH  - *Water-Electrolyte Balance/drug effects
MH  - *Weight Gain/drug effects
PMC - PMC6490859
EDAT- 2016/05/14 06:00
MHDA- 2017/03/28 06:00
PMCR- 2016/05/13
CRDT- 2016/05/14 06:00
PHST- 2015/10/02 00:00 [received]
PHST- 2016/03/14 00:00 [revised]
PHST- 2016/05/14 06:00 [entrez]
PHST- 2016/05/14 06:00 [pubmed]
PHST- 2017/03/28 06:00 [medline]
PHST- 2016/05/13 00:00 [pmc-release]
AID - CLC22547 [pii]
AID - 10.1002/clc.22547 [doi]
PST - ppublish
SO  - Clin Cardiol. 2016 Aug;39(8):446-52. doi: 10.1002/clc.22547. Epub 2016 May 13.