Giménez-Miranda Luis, Scagliusi Santiago F, Pérez-García Pablo, Olmo-Fernández Alberto, Huertas Gloria, Yúfera Alberto, Medrano Francisco J
Internal Medicine Department, Virgen del Rocío University Hospital, 41013 Seville, Spain.
Institute of Biomedicine of Seville (IBiS) - Virgen del Rocío University Hospital/University of Seville/Spanish National Research Council, 41013 Seville, Spain.
Rev Cardiovasc Med. 2024 Sep 6;25(9):315. doi: 10.31083/j.rcm2509315. eCollection 2024 Sep.
Heart failure (HF) represents a frequent cause of hospital admission, with fluid overload directly contributing to decompensations. Bioimpedance (BI), a physical parameter linked to tissue hydration status, holds promise in monitoring congestion and improving prognosis. This systematic review aimed to assess the clinical relevance of BI-based wearable devices for HF fluid monitoring.
A systematic review of the published literature was conducted in five medical databases (PubMed, Scopus, Cochrane, Web of Science, and Embase) for studies assessing wearable BI-measuring devices on HF patients following PRISMA recommendations on February 4th, 2024. The risk of bias was evaluated using the ROBINS tool.
The review included 10 articles with 535 participants (mean age 66.7 ± 8.9 years, males 70.4%). Three articles identified significant BI value differences between HF patients and controls or congestive vs non-congestive HF patients. Four articles focused on the devices' ability to predict HF worsening-related events, revealing an overall sensitivity of 70.0 (95% CI 68.8-71.1) and specificity of 89.1 (95% CI 88.3-89.9). One article assessed prognosis, showing that R decrease was related to all-cause-mortality with a hazard ratio (HR) of 5.51 (95% CI 1.55-23.32; = 0.02) and the composite all-cause-mortality and HF admission with a HR of 4.96 (95% CI 1.82-14.37; = 0.01).
BI-measuring wearable devices exhibit efficacy in detecting fluid overload and hold promise for HF monitoring. However, further studies and technological improvements are required to optimize their impact on prognosis compared to standard care before they can be routinely implemented in clinical practice.
The search protocol was registered at PROSPERO (CRD42024509914).
心力衰竭（HF）是住院的常见原因，液体超负荷直接导致病情恶化。生物阻抗（BI）是一种与组织水合状态相关的物理参数，在监测充血和改善预后方面具有潜力。本系统评价旨在评估基于生物阻抗的可穿戴设备在心力衰竭液体监测中的临床相关性。
2024年2月4日，按照PRISMA指南，在五个医学数据库（PubMed、Scopus、Cochrane、Web of Science和Embase）中对已发表的文献进行系统评价，以评估可穿戴生物阻抗测量设备在心力衰竭患者中的应用。使用ROBINS工具评估偏倚风险。
该评价纳入了10篇文章，共535名参与者（平均年龄66.7±8.9岁，男性占70.4%）。三篇文章发现心力衰竭患者与对照组或充血性心力衰竭与非充血性心力衰竭患者之间的生物阻抗值存在显著差异。四篇文章关注设备预测心力衰竭恶化相关事件的能力，总体敏感性为70.0（95%CI 68.8-71.1），特异性为89.1（95%CI 88.3-89.9）。一篇文章评估了预后，显示R值降低与全因死亡率相关，危险比（HR）为5.51（95%CI 1.55-23.32；P=0.02），与全因死亡率和心力衰竭住院的综合结果相关，HR为4.96（95%CI 1.82-14.37；P=0.01）。
可穿戴生物阻抗测量设备在检测液体超负荷方面显示出有效性，对心力衰竭监测具有潜力。然而，与标准治疗相比，在临床实践中常规应用之前，还需要进一步的研究和技术改进，以优化其对预后的影响。
PROSPERO注册：检索方案已在PROSPERO注册（CRD42024509914）。
