Bioimpedance vector analysis for detecting subclinical congestion in patients with decompensated heart failure

Aim

To evaluate the role of clinical and laboratory methods and bioimpedance vector analysis (BIVA) in assessing subclinical congestion in patients with decompensated heart failure.

Material and methods

We assessed hydration status using a congestion score and BIVA on admission and discharge in 97 patients (40.2% male, mean age 68.4±10.4 years) hospitalized with decompensated heart failure.

Results

On admission, 84% and 95% of patients had severe degree of hydration according to the congestion score and BIVA, respectively. On discharge, according to the congestion score there were no signs of overhydration (0-1 points) in 88% of patients. However, BIVA showed mild to severe hyperhydration in 66% of patients. The following factors predicted subclinical congestion after treatment: NTproBNP >1337 pg/ml on admission (odds ratio [OR] 6.010), LV EF <40% (OR 5.238), radiographic signs of congestion on admission (OR 4.391), intravenous furosemide dose >90 mg/day (OR 3.125).

Conclusion

At discharge from the hospital, BIVA showed the subclinical signs of congestion in two thirds of patients admitted with decompensated heart failure, despite the regression of clinical manifestations.

Key words

Decompensated heart failure, subclinical congestion, bioimpedance vector analysis.