Decreased Intrathoracic Impedance Associated With OptiVol Alert Can Diagnose Increased B-Type Natriuretic Peptide - MOMOTARO (Monitoring and Management of OptiVol Alert to Reduce Heart Failure Hospitalization) Study -

Circulation Journal : Official Journal of the Japanese Circulation Society
Nobuhiro NishiiMOMOTARO Investigators

Abstract

Ambulatory measurement of intrathoracic impedance (ITI) with an implanted device may detect increases in pulmonary fluid retention early, but the clinical utility of this method is not well established. The goal of this study was to test whether conventional ITI-derived parameters can diagnose fluid retention that may cause early stage heart failure (HF). HF patients implanted with high-energy devices with OptiVol (Medtronic) monitoring were enrolled in this study. Patients were monitored remotely. At both baseline and OptiVol alert, patients were assessed on standard examinations, including analysis of serum brain natriuretic peptide (BNP). From April 2010 to August 2011, 195 patients from 12 institutes were enrolled. There were 154 primary OptiVol alert events. BNP level at the alerts was not significantly different from that at baseline. Given that ITI was inversely correlated with log BNP, we added a criterion specifying that the OptiVol alert is triggered only when ITI decreases by ≥4% from baseline. This change improved the diagnostic potential of increase in BNP at OptiVol alert (sensitivity, 75%; specificity, 88%). BNP increase could not be identified based on OptiVol alert. Decrease in ITI ≥4% compared with baseline, i...Continue Reading

References

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Dec 20, 2011·Circulation·Véronique L RogerUNKNOWN American Heart Association Statistics Committee and Stroke Statistics Subcommittee
Jul 21, 2012·Circulation Journal : Official Journal of the Japanese Circulation Society·Kazuo AsadaRyozo Nagai
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Aug 2, 2013·Circulation Journal : Official Journal of the Japanese Circulation Society·Eiichi WatanabePedro Brugada

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Citations

Apr 29, 2015·Circulation Journal : Official Journal of the Japanese Circulation Society·Yoshihiro Seo, Kazutaka Aonuma
Nov 16, 2018·Circulation Journal : Official Journal of the Japanese Circulation Society·Junya TakagawaUNKNOWN PROST Investigators
Feb 14, 2020·Circulation Journal : Official Journal of the Japanese Circulation Society·Norimichi KoitabashiMasahiko Kurabayashi

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