Early Indication of Decompensated Heart Failure in Patients on Home-Telemonitoring: A Comparison of Prediction Algorithms Based on Daily Weight and Noninvasive Transthoracic Bio-impedance

JMIR Medical Informatics
Illapha Cuba GyllenstenJohn G F Cleland

Abstract

Heart Failure (HF) is a common reason for hospitalization. Admissions might be prevented by early detection of and intervention for decompensation. Conventionally, changes in weight, a possible measure of fluid accumulation, have been used to detect deterioration. Transthoracic impedance may be a more sensitive and accurate measure of fluid accumulation. In this study, we review previously proposed predictive algorithms using body weight and noninvasive transthoracic bio-impedance (NITTI) to predict HF decompensations. We monitored 91 patients with chronic HF for an average of 10 months using a weight scale and a wearable bio-impedance vest. Three algorithms were tested using either simple rule-of-thumb differences (RoT), moving averages (MACD), or cumulative sums (CUSUM). Algorithms using NITTI in the 2 weeks preceding decompensation predicted events (P<.001); however, using weight alone did not. Cross-validation showed that NITTI improved sensitivity of all algorithms tested and that trend algorithms provided the best performance for either measurement (Weight-MACD: 33%, NITTI-CUSUM: 60%) in contrast to the simpler rules-of-thumb (Weight-RoT: 20%, NITTI-RoT: 33%) as proposed in HF guidelines. NITTI measurements decrease befor...Continue Reading

References

May 30, 2001·European Journal of Heart Failure·C BerryJ J McMurray
Aug 18, 2004·Circulation·Philip B AdamsonUNKNOWN InSync III Model 8042 and Attain OTW Lead Model 4193 Clinical Trial Investigators
Jun 6, 2006·Journal of the American College of Cardiology·Milton PackerUNKNOWN Prospective Evaluation and Identification of Cardiac Decompensation by ICG Test (PREDICT) Study Investigators and Coordinato
Sep 30, 2006·Brain : a Journal of Neurology·Florian MormannKlaus Lehnertz
Feb 21, 2007·European Heart Journal·Dirk VollmannUNKNOWN European InSync Sentry Observational Study Investigators
Aug 19, 2007·Heart·Arend Mosterd, Arno W Hoes
Sep 12, 2007·Circulation·Sarwat I ChaudhryHarlan M Krumholz
Dec 6, 2007·Conference Proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society·Joerg Habetha
Dec 18, 2007·American Heart Journal·Gad CotterChristopher M O'Connor
Mar 4, 2010·Circulation. Heart Failure·Marc VanderheydenFrieder Braunschweig
Nov 18, 2010·The New England Journal of Medicine·Akshay S Desai, Lynne Warner Stevenson
Dec 22, 2010·Heart·John G F ClelandUNKNOWN National Heart Failure Audit Team for England and Wales
Feb 15, 2011·Lancet·William T AbrahamUNKNOWN CHAMPION Trial Study Group
May 10, 2011·Journal of Cardiac Failure·Philip B AdamsonRobert T Taepke
May 10, 2011·European Heart Journal·John G F Cleland, Renjith Antony
Jan 19, 2012·Conference Proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society·Harald ReiterAuli Sipilä
Mar 1, 2012·European Journal of Heart Failure·Patrik LyngåMårten Rosenqvist
Mar 30, 2013·European Journal of Heart Failure·Aldo P MaggioniUNKNOWN Heart Failure Association of the European Society of Cardiology (HFA)
Sep 17, 2014·Journal of Cardiovascular Medicine·Gabriella MalfattoGianfranco Parati
Dec 17, 2014·International Journal of Cardiology·Illapha Cuba-GyllenstenAntoni Bayes-Genis

❮ Previous
Next ❯

Citations

May 7, 2016·Expert Review of Cardiovascular Therapy·Lida Pieretta PapavasileiouMassimo Santini
Jan 18, 2017·BMC Medical Informatics and Decision Making·Illapha Cuba GyllenstenKevin M Goode
Jun 5, 2020·Current Heart Failure Reports·Arvind Singhal, Martin R Cowie
Aug 19, 2017·Trends in Cardiovascular Medicine·Joshua M PevnickIlan Kedan

❮ Previous
Next ❯

Methods Mentioned

BETA
coronary artery bypass

Software Mentioned

MATLAB
MACD
MyHeart
CUSUM
RoT

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.