Accuracy of bioimpedance vector analysis and brain natriuretic peptide in detection of peripheral edema in acute and chronic heart failure

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• 作者：Francesco Massari ; MD^a ; Massimo Iacoviello ; MD^b ; Pietro Scicchitano ; MD^a ; ^{piero.sc@hotmail.it" class="auth_mail" title="E-mail the corresponding author} ; ^{pietrosc.83@libero.it" class="auth_mail" title="E-mail the corresponding author} ; Filippo Mastropasqua ; MD^c ; Pietro Guida ; MD^d ; Graziano Riccioni ; MD^e ; Giuseppe Speziale ; MD^f ; Pasquale Caldarola ; MD^g ; Marco Matteo Ciccone ; MD^b ; Salvatore Di Somma ; MD^h
• 关键词：Peripheral congestion ; BIVA ; BNP ; Acute heart failure ; Chronic heart failure
• 刊名：Heart & Lung: The Journal of Acute and Critical Care
• 出版年：2016
• 出版时间：July-August 2016
• 年：2016
• 卷：45
• 期：4
• 页码：319-326
• 全文大小：694 K

文摘

To evaluate the role of bioelectrical impedance vector analysis (BIVA) and brain natriuretic peptide (BNP) in detecting peripheral congestion in heart failure (HF).

Background

BIVA/BNP are biomarkers for congestion in acute (ADHF) and chronic HF.

Methods

487 ADHF and 413 chronic HF patients underwent BIVA and BNP tests.

Results

BIVA was more accurate than BNP in detecting peripheral congestion both in ADHF (AUC 0.88 vs 0.57 respectively; p < 0.001) and chronic HF patients (AUC 0.89 vs 0.68, respectively; p < 0.001). In ADHF patients, the optimal BNP cut-off for discriminating presence or absence of edema was >870 pg/mL (PPV = 48% and NPV = 58%) whereas in chronic HF it was >216 pg/mL (PPV = 18% and NPV = 95%). The BIVA detected edema when the vector fell into the lower pole of 75th percentile tolerance ellipse (PPV = 84% and NPV = 78%) in ADHF, the lower pole of 50% (PPV = 68% and NPV = 95%) in chronic HF.

Conclusions

In HF patients, BIVA is an easy, fast technique to assess peripheral congestion, and is even more accurate than BNP.