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一种监测心力衰竭患者肺淤血的新方法:使用远程介电传感技术的初步动物及临床经验

A novel approach to monitoring pulmonary congestion in heart failure: initial animal and clinical experiences using remote dielectric sensing technology.

作者信息

Amir Offer, Rappaport Dan, Zafrir Barak, Abraham William T

机构信息

Department of Cardiovascular Medicine, Lady Davis Carmel Medical Center and the Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

出版信息

Congest Heart Fail. 2013 May-Jun;19(3):149-55. doi: 10.1111/chf.12021. Epub 2013 Jan 25.

Abstract

Despite current therapies and disease management approaches, rates of heart failure (HF) rehospitalization remain high. New tools are needed to assess preclinical (asymptomatic) pulmonary congestion to enable outpatient management. Hence, a novel monitoring system based on noninvasive remote dielectric sensing (ReDS) technology was developed. Validation of the ReDS technology was conducted in preclinical and clinical studies. In a porcine HF model, acute fluid overload followed by administration of diuretics were performed. Changes in ReDS values were correlated to serial computed tomographic (CT) assessments of lung fluid concentrations. In hospitalized decompensated HF patients, changes in ReDS values were correlated to net fluid balance changes. A nearly linear pattern between the changes in ReDS and CT fluid concentration values was observed in 6 discrete experiments (Intraclass correlation=0.95). Results from 24 patients demonstrated a reduction in ReDS values of 17.53%±11% throughout hospitalization, consistent with a reduction in pulmonary congestion. This finding strongly correlated with changes in net fluid balance (Pearson correlation=0.86; 95% confidence interval, 0.68-0.94; R(2) =0.74). These findings suggest that ReDS technology accurately quantifies lung fluid concentration and has potential for monitoring HF patients through hospitalization and possibly at home.

摘要

尽管有当前的治疗方法和疾病管理手段,但心力衰竭(HF)再住院率仍然很高。需要新的工具来评估临床前(无症状)肺充血情况,以便进行门诊管理。因此,开发了一种基于非侵入性远程介电传感(ReDS)技术的新型监测系统。在临床前和临床研究中对ReDS技术进行了验证。在猪HF模型中,先进行急性液体超负荷,然后给予利尿剂。ReDS值的变化与肺部液体浓度的系列计算机断层扫描(CT)评估相关。在住院的失代偿性HF患者中,ReDS值的变化与净液体平衡变化相关。在6个独立实验中观察到ReDS变化与CT液体浓度值之间呈现近乎线性的模式(组内相关系数=0.95)。24例患者的结果显示,整个住院期间ReDS值降低了17.53%±11%,这与肺充血的减轻一致。这一发现与净液体平衡的变化密切相关(Pearson相关系数=0.86;95%置信区间,0.68 - 0.94;R² =0.74)。这些发现表明,ReDS技术能够准确量化肺部液体浓度,并且有潜力在患者住院期间甚至可能在家中对HF患者进行监测。

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