Imamura Teruhiko, Izumida Toshihide, Narang Nikhil, Kinugawa Koichiro
Second Department of Internal Medicine, University of Toyama, Toyama 930-0194, Japan.
Advocate Christ Medical Center, Oak Lawn, IL 60453, USA.
J Clin Med. 2024 May 31;13(11):3245. doi: 10.3390/jcm13113245.
Remote dielectric sensing (ReDS) systems can estimate the amount of lung fluid non-invasively and easily without expert techniques. The correlation between the elevated ReDS value and other modalities that estimate pulmonary congestion has been validated. The clinical implications of lower ReDS values, which may indicate hypovolemia, remain unknown. A total of 138 patients who were hospitalized for various cardiovascular-related problems and underwent ReDS value measurements at the index discharge in a blinded manner to the attending clinicians were eligible for inclusion. Patients with ReDS values > 30%, indicating the presence of pulmonary congestion, were excluded. The prognostic impact of lower ReDS values on all-cause readmission after index discharge was evaluated. A total of 97 patients were included. The median age was 78 years, and 48 were men. The median ReDS value at index discharge was 26% (23%, 27%). A lower ReDS value correlated with smaller inferior vena cava maximum diameters (r = 0.46, < 0.001) and higher blood urea nitrogen/creatinine ratios (r = -0.35, < 0.001). A lower ReDS value (≤25%) was associated with a risk of all-cause readmissions with an unadjusted hazard ratio of 2.68 (95% confidence interval 1.09-6.59, = 0.031) and an adjusted hazard ratio of 2.30 (95% confidence interval 0.92-5.78, = 0.076). Its calculated cutoff of 25% significantly stratified the cumulative incidence of the primary outcome (36% versus 17%, = 0.038). A lower ReDS value may indicate hypovolemia and be associated with the risk of all-cause readmission in patients hospitalized for cardiovascular diseases.
远程介电传感(ReDS)系统无需专业技术就能轻松、无创地估算肺液量。ReDS值升高与其他评估肺充血的方式之间的相关性已得到验证。较低的ReDS值可能表明血容量不足,但其临床意义尚不清楚。共有138例因各种心血管相关问题住院的患者符合纳入标准,这些患者在出院时以对主治医生保密的方式进行了ReDS值测量。ReDS值>30%表明存在肺充血的患者被排除。评估了较低的ReDS值对出院后全因再入院的预后影响。共纳入97例患者。中位年龄为78岁,男性48例。出院时的中位ReDS值为26%(23%,27%)。较低的ReDS值与较小的下腔静脉最大直径相关(r = 0.46,<0.001),与较高的血尿素氮/肌酐比值相关(r = -0.35,<0.001)。较低的ReDS值(≤25%)与全因再入院风险相关,未调整的风险比为2.68(95%置信区间1.09 - 6.59,P = 0.031),调整后的风险比为2.30(95%置信区间0.92 - 5.78,P = 0.076)。其计算得出的25%的临界值显著分层了主要结局的累积发生率(36%对17%,P = 0.038)。较低的ReDS值可能表明血容量不足,并与因心血管疾病住院患者的全因再入院风险相关。