Second Department of Internal Medicine, University of Toyama, Toyama, Japan.
ESC Heart Fail. 2024 Jun;11(3):1443-1451. doi: 10.1002/ehf2.14690. Epub 2024 Feb 14.
Remote dielectric sensing (ReDS) represents a contemporary non-invasive technique reliant on electromagnetic energy to quantify pulmonary congestion. Its prognostic significance within the context of heart failure (HF) patients remains elusive. This study aimed to assess the prognostic implications of residual pulmonary congestion, as gauged by the ReDS system, among patients admitted due to congestive HF.
We enrolled hospitalized HF patients who underwent ReDS assessments upon admission and discharge in a blinded manner, independent of attending physicians. We evaluated the prognostic impact of the ReDS ratio between admission and discharge on the primary outcome, which encompassed all-cause mortality and HF-related re-hospitalizations. A cohort of 133 patients (median age 78 [72, 84] years, 78 male [59%]) was included. Over a median observation period of 363 days post-index discharge, an escalated ReDS group (ReDS ratio > 100%), determined through statistical calculation, emerged as an independent predictor of the primary outcome, exhibiting an adjusted hazard ratio of 4.37 (95% confidence interval 1.13-16.81, P = 0.032). The cumulative incidence of the primary outcome was notably higher in the increased ReDS group compared with the decreased ReDS group (50.1% vs. 8.5%, P = 0.034).
Elevated ReDS ratios detected during the index hospitalization could serve as a promising prognostic indicator in HF patients admitted for treatment. The clinical ramifications of ReDS-guided HF management warrant validation in subsequent studies.
远程介电感应(ReDS)代表一种现代的非侵入性技术,依赖于电磁能来量化肺充血。它在心衰(HF)患者中的预后意义仍不清楚。本研究旨在评估充血性 HF 患者入院时和出院时通过 ReDS 系统测量的残余肺充血的预后意义。
我们以盲法方式纳入了入院时和出院时接受 ReDS 评估的住院 HF 患者,独立于主治医生。我们评估了入院和出院时的 ReDS 比值对主要结局的预后影响,主要结局包括全因死亡率和 HF 相关再住院率。共纳入了 133 例患者(中位数年龄 78 [72,84] 岁,78 名男性[59%])。在指数出院后中位 363 天的观察期间,通过统计计算确定的递增 ReDS 组(ReDS 比值>100%)是主要结局的独立预测因子,调整后的危险比为 4.37(95%置信区间 1.13-16.81,P=0.032)。与 ReDS 比值降低组相比,递增 ReDS 组的主要结局累积发生率明显更高(50.1% vs. 8.5%,P=0.034)。
在住院期间检测到的升高的 ReDS 比值可作为 HF 患者入院治疗的有前途的预后指标。需要在后续研究中验证 ReDS 指导 HF 管理的临床意义。