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Correlation of endorgan function and bioimpedance measurement in patients with advanced heart failure

Session Poster Session 1

Speaker Luise Roehrich

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure – Epidemiology, Prognosis, Outcome
  • Session type : Poster Session

Authors : L Roehrich (Berlin,DE), J Knierim (Berlin,DE), J Mulzer (Berlin,DE), M Mueller (Berlin,DE), V Falk (Berlin,DE), C Starck (Berlin,DE), E Potapov (Berlin,DE), S Suendermann (Berlin,DE), F Schoenrath (Berlin,DE)

Authors:
L Roehrich1 , J Knierim1 , J Mulzer1 , M Mueller1 , V Falk1 , C Starck1 , E Potapov1 , S Suendermann2 , F Schoenrath1 , 1Deutsches Herzzentrum Berlin, Cardiothoracic and Vascular Surgery - Berlin - Germany , 2Charite - Campus Virchow-Klinikum (CVK), Cardiothoracic Surgery - Berlin - Germany ,

Citation:

Introduction:

Bio impedance analysis (BIA) is a non-invasive, low-cost tool to assess frailty. The impact of end-organ dysfunction on the results of BIA is unknown. Impaired renal and cardiac function can cause a fluid shift from the intravascular to the extravascular space and have an impact on the nutritional status of the patient and may cause changes in the phase angle (PA). The PA represents the relationship between resistance and reactance of tissue in the BIA and is mostly influenced by cell mass and water. Laboratory parameters indicative of heart failure, renal and liver function were collected and correlated with the PA.

Methods:

In 50 patients (45 female, 5 male) with end-stage heart failure, a BIA measurement was performed prior to LVAD implantation and correlated to NT-proBNP, creatinine, eGFR, albumin, total bilirubin and MELD-XI-Score. Additionally, the correlation between phase angle hemoglobin and hematocrit as a representative of the intravascular fluid status of the patient was assessed. The trial protocol was approved by the local ethics committee (ES2/236/17).

Results:

Mean age was 59.9 years (+/-10.4), mean NT-proBNP was 12169pg/ml (+/-11737). 25 (50%) patients were in INTERMACS level I or II, 12 (24%) were stable on inotropic support (IM III) and 13 (26%) patients were in IM level IV. 16 (32%) patients suffered from dilated cardiomyopathy, 31 (62%) patients had ischemic heart disease and 3 (6%) had other reasons for heart failure. 28 (56%) patients had an eGFR under 50 ml/min/1.73 m2. The mean phase angle was 4.0 (+/-1.32). The correlation with laboratory parameters was tested for with the Gaussian distribution ,Kolmogorov-Smirnov-Test and spearman correlation test. The PA correlated strongly with hemoglobin (rs = .46, p < 0.01), hematocrit (rs=.42, p < 0.01) and as expected albumin (rs=0.48, p < 0.01). A weak correlation was found between MELD-XI-Score and PA (rs=-.28, p < 0.05). There was no correlation between PA and creatinine, eGFR, total bilirubin and NT-proBNP.

Conclusion:

The PA had no correlation with routinely used parameters to assess outcome in heart failure patients (NT-proBNP, eGFR, bilirubine). Therefore this parameter might be used to add independent information about frailty in this patient cohort but further investigation and outcome correlation for BIA measurement in heart failure patients is strongly needed.

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