Bioelectrical impedance spectroscopy (BIS) measures body composition, including fluid status. Acute decompensated heart failure (ADHF) is associated with fluid overload in different body compartments. This investigation aimed to evaluate the feasibility of measuring and monitoring fluid accumulation in patients with ADHF using BIS. The extracellular impedance as a surrogate marker for fluid accumulation was measured in 67 participants (25 healthy reference volunteers and 42 patients admitted with ADHF) using BIS in the "transthoracic", "foot-to-foot", "whole-body" and "hand-to-hand" segments. At baseline, BIS showed significantly lower extracellular resistance values for the "whole-body" (P < 0.001), "foot-to-foot" (P = 0.03), "hand-to-hand" (P < 0.001) and "transthoracic" (P = 0.014) segments in patients with ADHF than the reference cohort, revealing a specific pattern for peripheral, central and general fluid accumulation. The "foot-to-foot" (AUC = 0.8, P < 0.001) and "hand-to-hand" (AUC = 0.74, P = 0.04) segments indicated compartments of fluid accumulation with good prediction. During cardiac recompensation, BIS values changed significantly and were in line with routine parameters for monitoring ADHF. Mean bodyweight change per day correlated moderately to good with BIS values in the "whole-body" (r = −0.4), "foot-to-foot" (r = −0.8) and "transthoracic" (r = −0.4) segments. Based on our analysis, we conclude that measuring and monitoring fluid accumulation in ADHF using segmental BIS is feasible and correlates with clinical parameters during recompensation. Acute decompensated heart failure (ADHF) is typically associated with forward or backward pumping failure 1. It is considered a severe health deterioration that frequently leads to hospital admission. Typical clinical symptoms of worsening heart failure are associated with central, peripheral or general fluid overload and include breathlessness and oedema. In addition to the treatment of the underlying cause of ADHF, removal of the excess fluid load in the body is a central aspect of ADHF management 1,2. However, individual clinical signs of volume overload, such as breathlessness and peripheral oedema, show wide variation. Thus, clinical presentation may be unspecific, but identifying fluid overload and ADHF 3 is paramount to guide adequate treatment. To diagnose and monitor ADHF, the combination of biomarkers such as NT-proBNP 4 , bodyweight, ECG 5,6 , echocardiography 7,8 , functional 9 and imaging 7,10 findings in addition to the clinical aspect of the patient are considered pillars of clinical management. However, the identification and monitoring of fluid overload by these techniques are limited and mostly hampered by an overlap with concomitant critical health conditions 11. Thus, differing impedance measurement techniques to determine body composition, fluid load and organ functionality by invasive 12-15 or non-invasive 16-27 approaches may be a potential supplement and extent to current diagnostic possibilities. The electrical impedance of tissue ...
Neuroendocrine chromaffin cells of the adrenal gland express certain molecular markers either transiently during development or permanently. In the present study, the expression of neuromodulin (GAP-43), a neuronal protein often associated with neurite outgrowth, was examined in adult adrenals. Neuromodulin was detected by Western blot analysis in extracts of both rat adrenals and cultured bovine chromaffin cells, and was localized in situ in a subpopulation of chromaffin cells, as well as in nerve fibres and Schwann cells. The use of anti-tyrosine hydroxylase or anti-phenylethanolamine N-methyltransferase antibodies in combination with anti-neuromodulin antibodies in double immunofluorescent labelling of cryostat sections of rat glands demonstrated that neuromodulin is expressed by noradrenergic, and not by adrenergic chromaffin cells. The results provide further evidence that neuromodulin is not limited to neurons; it is also expressed in a subpopulation of neuroendocrine chromaffin cells. Neuromodulin may play a role in the development of the adrenal medulla or in the specific regulation of noradrenalin secretion from chromaffin cells.
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