학술논문
The role of bioimpedance analysis in overweight and obese patients with acute heart failure: a pilot study
Document Type
Clinical report
Author
Venegas‐Rodríguez, Ana; Pello, Ana María; López‐Castillo, Marta; Urquía, Mikel Taibo; Balaguer‐Germán, Jorge; Munté, Alicia; González‐Martín, Guillermo; Carriazo‐Julio, Sol María; Martínez‐Milla, Juan; Kallmeyer, Andrea; Lorenzo, Óscar González; Slocker, Hans Paul Gaebelt; Tuñón, José; González‐Parra, Emilio; Aceña, Álvaro
Source
ESC Heart Failure. August 2023, Vol. 10 Issue 4, p2418, 9 p.
Subject
Language
English
Abstract
Introduction Heart failure (HF) is a global pandemic affecting more than 64 million people worldwide and is increasing in prevalence due to aging of the population, improved treatment of, and [...]
: Aims: Residual congestion at the time of hospital discharge is an important readmission risk factor, and its detection with physical examination and usual diagnostic techniques have strong limitations in overweight and obese patients. New tools like bioelectrical impedance analysis (BIA) could help to determine when euvolaemia is reached. The aim of this study was to investigate the usefulness of BIA in management of heart failure (HF) in overweight and obese patients. Methods and results: Our study is a single‐centre, single‐blind, randomized controlled trial that included 48 overweight and obese patients admitted for acute HF. The study population was randomized into two arms: BIA‐guided group and standard care. Serum electrolytes, kidney function, and natriuretic peptides were followed up during their hospital stay and at 90 days after discharge. The primary endpoint was development of severe acute kidney injury (AKI) defined as an increase in serum creatinine by >0.5 mg/dL during hospitalization, and the main secondary endpoint was the reduction of N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) levels during hospitalization and within 90 days after discharge. The BIA‐guided group showed a remarkable lower incidence of severe AKI, although no significant differences were found (41.4% vs. 16.7%; P = 0.057). The proportion of patients who achieved levels of NT‐proBNP < 1000 pg/mL at 90 days was significantly higher in the BIA‐guided group than in the standard group (58.8% vs. 25%; P = 0.049). No differences were observed in the incidence of adverse outcomes at 90 days. Conclusions: Among overweight and obese patients with HF, BIA reduces NT‐proBNP levels at 90 days compared with standard care. In addition, there is a trend towards lower incidence of AKI in the BIA‐guided group. Although more studies are required, BIA could be a useful tool in decompensated HF management in overweight and obese patients.
: Aims: Residual congestion at the time of hospital discharge is an important readmission risk factor, and its detection with physical examination and usual diagnostic techniques have strong limitations in overweight and obese patients. New tools like bioelectrical impedance analysis (BIA) could help to determine when euvolaemia is reached. The aim of this study was to investigate the usefulness of BIA in management of heart failure (HF) in overweight and obese patients. Methods and results: Our study is a single‐centre, single‐blind, randomized controlled trial that included 48 overweight and obese patients admitted for acute HF. The study population was randomized into two arms: BIA‐guided group and standard care. Serum electrolytes, kidney function, and natriuretic peptides were followed up during their hospital stay and at 90 days after discharge. The primary endpoint was development of severe acute kidney injury (AKI) defined as an increase in serum creatinine by >0.5 mg/dL during hospitalization, and the main secondary endpoint was the reduction of N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) levels during hospitalization and within 90 days after discharge. The BIA‐guided group showed a remarkable lower incidence of severe AKI, although no significant differences were found (41.4% vs. 16.7%; P = 0.057). The proportion of patients who achieved levels of NT‐proBNP < 1000 pg/mL at 90 days was significantly higher in the BIA‐guided group than in the standard group (58.8% vs. 25%; P = 0.049). No differences were observed in the incidence of adverse outcomes at 90 days. Conclusions: Among overweight and obese patients with HF, BIA reduces NT‐proBNP levels at 90 days compared with standard care. In addition, there is a trend towards lower incidence of AKI in the BIA‐guided group. Although more studies are required, BIA could be a useful tool in decompensated HF management in overweight and obese patients.