Division of Cardiology, Department of Internal Medicine, Heart Failure Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan.
J Cardiovasc Med (Hagerstown). 2012 May;13(5):299-306. doi: 10.2459/JCM.0b013e328351677f.
A segmental multifrequency bioelectrical impedance analysis (SMBIA) is a noninvasive and reproducible modality for estimating the fluid state. The aim of this study was to test whether the SMBIA-derived edema index provides prognostic value in patients hospitalized due to acute heart failure (AHF).
To estimate the 6-month prognostic value of the predischarge edema index in patients hospitalized due to AHF, 112 patients were consecutively enrolled. Both predischarge edema index and B-type natriuretic peptide (BNP) were measured. Outcome follow-up focused on heart failure-related and all-cause re-hospitalizations and all events.
On the basis of a cutoff value of edema index of 0.390, patients were separated into two groups: edema index more than 0.390 (n = 44) and edema index of 0.390 or less (n = 68). Compared with patients with edema index 0.390 or less, those with edema index of more than 0.390 were older, had lower blood albumin and hemoglobin levels, and had higher predischarge BNP levels, functional class, incidence of diabetes mellitus, valvular cause, and diuretic use. Although edema indexes were correlated with BNP levels (r = 0.47, P < 0.0001), a mismatch was noted in 33 (29%) patients. Univariate and multivariate analysis showed that an edema index of more than 0.390 predicted a higher incidence of heart failure-related re-hospitalization [odds ratio (OR) = 4.14, confidence interval (CI) = 1.05-15.28, P = 0.04] and all events (OR = 3.97, CI = 1.4-11.25, P = 0.01). The edema index provided a prognostic value superior to that of BNP. Reducing the edema index in high-risk patients resulted in fewer heart failure-related re-hospitalizations (OR = 0.81, CI = 0.77-0.84, P < 0.001) and all events (OR = 0.8, CI = 0.76-0.85, P < 0.001).
Edema index provides 6-month prognostic values in patients hospitalized due to AHF. Reducing the edema index in high-risk patients results in better outcomes.
节段多频生物电阻抗分析（SMBIA）是一种用于评估体液状态的非侵入性、可重复的方法。本研究旨在检验 SMBIA 衍生的水肿指数在因急性心力衰竭（AHF）住院的患者中是否具有预后价值。
为了评估患者出院时水肿指数对急性心力衰竭住院患者 6 个月预后的预测价值，连续纳入 112 例患者。测量患者出院时的水肿指数和 B 型利钠肽（BNP）。预后随访的重点是心力衰竭相关和全因再住院以及所有事件。
基于水肿指数的截断值 0.390，患者被分为两组：水肿指数大于 0.390（n=44）和水肿指数等于或小于 0.390（n=68）。与水肿指数等于或小于 0.390 的患者相比，水肿指数大于 0.390 的患者年龄更大，血白蛋白和血红蛋白水平更低，出院前 BNP 水平、功能分级、糖尿病发病率、瓣膜性病因和利尿剂使用更高。尽管水肿指数与 BNP 水平相关（r=0.47，P<0.0001），但在 33 例（29%）患者中存在不匹配。单因素和多因素分析显示，水肿指数大于 0.390 预测心力衰竭相关再住院的发生率更高[比值比（OR）=4.14，95%置信区间（CI）=1.05-15.28，P=0.04]和所有事件（OR=3.97，95%CI=1.4-11.25，P=0.01）。水肿指数提供的预后价值优于 BNP。降低高危患者的水肿指数可减少心力衰竭相关再住院（OR=0.81，95%CI=0.77-0.84，P<0.001）和所有事件（OR=0.8，95%CI=0.76-0.85，P<0.001）。
水肿指数为因急性心力衰竭住院的患者提供 6 个月的预后价值。降低高危患者的水肿指数可改善预后。
