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Correlation of impedance cardiography with invasive hemodynamic measurements in patients with advanced heart failure: The BioImpedance Cardi
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| 06.08.2009, 22:09 |
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Background Impedance cardiography (ICG) is a noninvasive modality that uses changes in impedance across the
thorax to assess hemodynamic parameters, including cardiac output (CO). The utility of ICG in patients hospitalized with heart
failure is uncertain.
Methods The BioImpedance CardioGraphy in Advanced Heart Failure study was a prospective substudy of the
Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness. A total of 170 subjects
underwent blinded ICG measurements using BioZ (CardioDynamics, San Diego, CA); of these, 82 underwent right heart
catheterization. We compared ICG with invasively measured hemodynamics by simple correlation and compared overall
ICG hemodynamic profiles ( “wet” [thoracic fluid content ≥47/kOhm in men and ≥37/kOhm in women] and “cold”
[cardiac index ≤2.2 L min−1m−2) versus those determined by invasive measurements (wet [pulmonary capillary wedge
pressure ≥22 mm Hg] and cold [cardiac index ≤2.2 L min−1m−2). We also determined whether ICG measurements were
associated with subsequent death or hospitalization within 6 months.
Results There was modest correlation between ICG and invasively measured CO (r = 0.4 to 0.6 on serial measurement).
Thoracic fluid content measured by ICG was not a reliable measure of pulmonary capillary wedge pressure. There was poor
agreement between ICG and invasively measured hemodynamic profiles ( κ ≤0.1). No ICG variable alone or in combination
was associated with outcome.
Conclusions In hospitalized patients with advanced heart failure, ICG provides some information about CO but not leftsided
filling pressures. Impedance cardiography did not have prognostic utility in this patient population. (Am Heart J
2009;158:217-23.)
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| Категория: Статьи | Добавил: nbylova
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