Utility of Impedance Cardiography for the Identification of Short-Term Risk of Clinical Decompensation in Stable Patients With Chronic Heart Failure

Packer, Milton; Abraham, William T.; Mehra, Mandeep R.; Yancy, Clyde W.; Lawless, Christine E.; Mitchell, Judith E.; Smart, Frank W.; Bijou, Rachel; O’Connor, Christopher M.; Massie, Barry M.; Piña, Ileana L.; Greenberg, Barry; Young, James B.; Fishbein, Daniel P.; Hauptman, Paul J.; Bourge, Robert C.; Strobeck, John E.; Murali, Srinvivas; Schocken, Douglas D.; Teerlink, John R.; Levy, Wayne C.; Trupp, Robin J.; Silver, Marc A.

doi:10.1016/j.jacc.2005.12.071

Cited by 175 publications

(109 citation statements)

References 26 publications

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“…Therefore, careful assessment of the fluid status prior to the initiation of and during CRRT is required. In this regard, impedance cardiography (ICG) is a subtle and non-invasive method of evaluating hemodynamic parameters (12) value in a previous study by our group on the management of CML-associated ARF (5).…”

Section: Introductionmentioning

confidence: 99%

Acute kidney injury in cancer patients and impedance cardiography‑assisted renal replacement therapy: Experience from the onconephrology unit of a Chinese tertiary hospital

Wang

Zhang²,

et al. 2017

Exp Ther Med

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Abstract. Acute kidney injury (AKI) in cancer patients may disrupt anticarcinogenic treatment and greatly increase associated mortality rates. The present study reported on the management of cancer patients with AKI and, from the nephrologic viewpoint, on the significance of fine volume control during the continuous renal replacement therapy (CRRT). The records of 117 cancer patients with AKI treated over three years were reviewed and their data were compared with those of 120 healthy controls. AKI was defined according to the Kidney Disease: Improving Global Outcomes criteria with serum creatinine levels determined on initial admission and for the diagnosis of AKI. CRRT with concomitant impedance cardiography (ICG) monitoring was performed in 79 patients. On average, AKI manifested as a 1.68±0.38-fold increase in serum creatinine within 10.2±5.7 days. The causes of AKI were diverse, with the major ones being nephrotoxic agents, hypotension and obstructive nephropathy. Renal biopsy confirmed two cases of thrombotic microangiopathy, due to the use of interfon-α and sunitinib malate, respectively, and a third case of cast nephropathy caused by immunoglobulin D multiple myeloma. The patients were generally marantic and had compromised cardiac function compared with the healthy controls. The CRRT prescription was discriminatingly optimized by the ICG parameters effecting discreet fluid balance, as the thoracic fluid content was significantly correlated with the ultrafiltration rate. By considering the causative mechanisms and applying subtle ICG-assisted volume control, the present study may thus help to improve the safety and efficacy of CRRT in cancer patients with AKI. In addition, it provided information to bring advances in onconephrology, a novel nephrological subspecialty field.

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Section: Introductionmentioning

confidence: 99%

Acute kidney injury in cancer patients and impedance cardiography‑assisted renal replacement therapy: Experience from the onconephrology unit of a Chinese tertiary hospital

Wang

Zhang²,

et al. 2017

Exp Ther Med

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“…Impedance cardiography has been used for many clinical purposes. It has been used for diagnosing several cardiovascular diseases such as heart failure [9][10] and myocardial infarction [11]. Moreover, it has been used to detect ischemia [12].…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of mitral insufficiency using impedance cardiography technique ICG

Chabchoub

Mansouri

Salah

2016

Journal of Electrical Bioimpedance

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Impedance cardiography (ICG) is a non-invasive tool for assessing the hemodynamic parameters. It has been used for diagnosing several cardiovascular diseases, such as heart failure, cardiomyopathy, and valvular diseases. Particularly, the valvular heart disease is characterized by the damage in one of the four heart valves: the mitral, aortic, tricuspid or pulmonary valves. The mitral valve insufficiency and the aortic valve stenos are the most frequent valve diseases in the world. In this paper, we propose to diagnosis the mitral valve insufficiency using the impedance cardiography technique. The study group consisted of 40 subjects (20 control subjects and 20 patients with mitral insufficiency). A parameter "I" is calculated from the impedance cardiogram waveform and it is used to differentiate control subjects from patients with mitral insufficiency. The parameter "I" was related significantly to the abnormalities of the impedance cardiogram waveform. For patients with mitral insufficiency, "I" was higher than for the healthy subjects with a difference ratio of 89% (p<0.001). To improve the diagnosis, we determined the stroke volume, cardiac output, and other hemodynamic parameters for the two groups of subjects. Finally, we concluded that we could identify, easily, patients with mitral insufficiency based on the abnormalities of the impedance cardiogram tracings and a characteristic parameter "I".

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“…lectrical Bioimpedance (EBI) have shown to be a useful tool for the supervision of the body hydration and fluid accumulation in several applications like Body Composition Assessment (BCA), detection of lymphedema, [1,2] and also for assessment of cardiac function via impedance cardiography [2]. Traditionally Electrical Bioimpedance Spectroscopy (EBIS) measurements for BCA are performed with electrolytic electrodes in a tetra-polar configuration.…”

Section: Introductionmentioning

confidence: 99%

“…Usually, the electrodes are placed on the foot-ankle and hand-wrist to perform measurements for whole body measurements [3]. The electrode produces a skin-electrode interface with an area defined by its size, around 10 cm 2 . Variations in the quality of the skin electrode interface may affect the electrode polarization impedance (Z ep ) of one or more electrodes.…”

Section: Introductionmentioning

confidence: 99%

Skin-electrode contact area in electrical bioimpedance spectroscopy. Influence in total body composition assessment

Márquez

Seoane

Lindecrantz

2011

2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society

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Electrical Bioimpedance Spectroscopy (EBIS) has been widely use for assessment of total body composition and fluid distribution. (EBIS) measurements are commonly performed with electrolytic electrodes placed on the wrist and the ankle with a rather small skin-electrode contact area. The use of textile garments for EBI requires the integration of textrodes with a larger contact area surrounding the limbs in order to compensate the absence of electrolytic medium commonly present in traditional Ag/AgCl gel electrodes. Recently it has been shown that mismatch between the measurements electrodes might cause alterations on the EBIS measurements. When performing EBIS measurements with textrodes certain differences have been observed, especially at high frequencies, respect the same EBIS measurements using Ag/AgCl electrodes. In this work the influence of increasing the skinelectrode area on the estimation of body composition parameters has been study performing experimental EBIS measurement. The results indicate that an increment on the area of the skin-electrode interface did produce noticeable changes in the bioimpedance spectra as well as in the body composition parameters. This influence must be taken into consideration when designing and testing textile-enable EBIS measurement systems.

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Utility of Impedance Cardiography for the Identification of Short-Term Risk of Clinical Decompensation in Stable Patients With Chronic Heart Failure

Abstract: These results suggest that when performed at regular intervals in stable patients with HF with a recent episode of clinical decompensation, ICG can identify patients at increased near-term risk of recurrent decompensation.

Cited by 175 publications

References 26 publications

Acute kidney injury in cancer patients and impedance cardiography‑assisted renal replacement therapy: Experience from the onconephrology unit of a Chinese tertiary hospital

Acute kidney injury in cancer patients and impedance cardiography‑assisted renal replacement therapy: Experience from the onconephrology unit of a Chinese tertiary hospital

Diagnosis of mitral insufficiency using impedance cardiography technique ICG

Skin-electrode contact area in electrical bioimpedance spectroscopy. Influence in total body composition assessment

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