A Current Review of the Uses of Bioelectrical Impedance Analysis and Bioelectrical Impedance Vector Analysis in Acute and Chronic Heart Failure Patients: An Under-valued Resource?

Abstract

Background There is a need to detect and prevent fluid overload and malnutrition in heart failure. Bioelectrical impedance analysis and bioelectrical impedance vector analysis are medical instruments that can advance heart failure management by generating values of body composition and body water, assisting clinicians to detect fluid and nutritional status. However, there is a lack of evidence to summarise how they have been used among heart failure patients. Method A systematic search was conducted. Result Two hundred and four papers were screened. Forty-eight papers were reviewed, and 46 papers were included in this review. The literature shows that bioelectrical impedance analysis and bioelectrical impedance vector analysis were mostly used to assess fluid and nutritional status, together with diagnostic and prognostic values. Contraindication of using BIA and implications for practice are also demonstrated. Conclusion The findings suggest that bioelectrical impedance vector analysis is superior to bioelectrical impedance analysis when assessing hydration/nutritional status in heart failure. Assessing a patient using bioelectrical impedance analysis /bioelectrical impedance vector analysis, together with natriuretic peptide -heart failure biomarkers, increases the diagnostic accuracy of heart failure. Further studies are required to examine the cost effectiveness of using these instruments in clinical practice.

Monitoring Water Balance to Predict Hospitalization in Patients with Chronic Heart Failure: A Retrospective Study

“…Recently, it has been recognized that the measurement of body fluid volume by BIA is effective in various diseases. In acute heart failure, BIA is considered a useful method of inferring congestive status [27][28][29]. Indeed, using emergency department patients, Park et al showed that the cut-off value of the ECW/TBW ratio to predict acute heart failure was >0.412 [30].…”

Evaluating Nutritional Risk Factors for Delirium in Intensive-Care-Unit Patients: Present Insights and Prospects for Future Research

“…This method plots the direct impedance resistance and reactance measurements as a bivariate vector in a nomogram [46]. BIVA has been reported to be useful for monitoring hydration status during fluid removal in patients with decompensated heart failure [47,48] and during intermittent hemodialysis [49,50]. Therefore, it can also prove useful in patients who are seriously ill. ↓ small portion of muscle, dehydration/insufficient fluid intake…”

Bioelectrical impedance vector analysis is different according to the comorbidity burden in post–acute myocardial infarction

“…BIVA can provides a qualitative information about the BC, hydration status, and cell mass of patients, regardless of body weight, thus representing a better predictor of nutrition in many types of clinical conditions 11,12,14–17 . Overhydration is associated with cardiovascular complications, so the possibility of testing its usefulness for detecting early changes that indicate fluid alterations and could help reduce the number of complications 18,19 . To date, no study has analyzed hydration and cellularity in patients post‐AMI using the BIVA method, and its relationship with the comorbidity burden.…”

“…11,12,[14][15][16][17] Overhydration is associated with cardiovascular complications, so the possibility of testing its usefulness for detecting early changes that indicate fluid alterations and could help reduce the number of complications. 18,19 To date, no study has analyzed hydration and cellularity in patients post-AMI using the BIVA method, and its relationship with the comorbidity burden. Therefore, this study aimed to investigate the relationship between comorbidity burden and the characteristics of the BIVA in patients post-AMI.…”