Measuring Impedance in Congestive Heart Failure

The aim of this study is to explore methods to detect fluid retention in the lungs by measuring the thoracic impedance, so we can monitor congestion heart failure patients, and physicians can early detect acute episodes. In order to acquire the data we will measure the thoracic impedance where we can determinate the accumulation of fluid in the lungs. Materials, such as blood or muscle, have a higher conductivity in comparison to bones or fat, and a lung filled with liquid has a higher conductivity than an air filled one. The purpose of the work is to develop a small and portable device to extract thorax impedance of the patient, it should be low cost and friendly to use so it can be operated by a big range of social classes and also have a low power consumption for portable use. The possibility that a patient can monitor his own body fluid by himself at home and be observed remotely by a doctor, would help to reduce drastically the number of hospitalizations and, consequently, improve the lifestyle of people diagnosed with heart failure

The effects of short-term omission of daily medication on the pathophysiology of heart failure

Aims Pharmacological therapies for heart failure (HF) aim to improve congestion, symptoms, and prognosis. Failing to take medication is a potential cause of worsening HF. Characterizing the effects of short-term medication omission could inform the development of better technologies and strategies to detect and interpret the reasons for worsening HF. We examined the effect of planned HF medication omission for 48 h on weight, echocardiograms, transthoracic bio-impedance, and plasma concentrations of NT-proBNP. Methods and results Outpatients with stable HF and an LVEF <45% were assigned to take or omit their HF medication for 48 h in a randomized, crossover trial. Twenty patients (16 men, LVEF 32 ± 9%, median NT-proBNP 962 ng/L) were included. Compared with regular medication, omission led to an increase in NT-proBNP by 99% (from 962 to 1883 ng/L, P < 0.001), systolic blood pressure by 16% (from 131 to 152 mmHg, P < 0.001), and left atrial volume by 21% (from 69 to 80 mL, P = 0.001), and reductions in transthoracic bio-impedance by 10% (from 33 to 30 Σ, P = 0.001) and serum creatinine by 8% (from 135 to 118 µmol/L, P = 0.012). No significant changes in body weight, heart rate, or LVEF were observed. Conclusions The characteristic pattern of response to short-term medication omission is of increasing congestion but, in contrast to the pattern reported for disease progression, with a rise in blood pressure and improved renal function. In stable HF, weight is not a sensitive marker of short-term diuretic omission

Assessing and grading congestion in acute heart failure: a scientific statement from the acute heart failure committee of the heart failure association of the European society of cardiology and endorsed by the European society of intensive care medicine

Patients with acute heart failure (AHF) require urgent in-hospital treatment for relief of symptoms. The main reason for hospitalization is congestion, rather than low cardiac output. Although congestion is associated with a poor prognosis, many patients are discharged with persistent signs and symptoms of congestion and/or a high left ventricular filling pressure. Available data suggest that a pre-discharge clinical assessment of congestion is often not performed, and even when it is performed, it is not done systematically because no method to assess congestion prior to discharge has been validated. Grading congestion would be helpful for initiating and following response to therapy. We have reviewed a variety of strategies to assess congestion which should be considered in the care of patients admitted with HF. We propose a combination of available measurements of congestion. Key elements in the measurement of congestion include bedside assessment, laboratory analysis, and dynamic manoeuvres. These strategies expand by suggesting a routine assessment of congestion and a pre-discharge scoring system. A point system is used to quantify the degree of congestion. This score offers a new instrument to direct both current and investigational therapies designed to optimize volume status during and after hospitalization. In conclusion, this document reviews the available methods of evaluating congestion, provides suggestions on how to properly perform these measurements, and proposes a method to quantify the amount of congestion presen

Microwave System for the Early Stage Detection of Congestive Heart Failure

Fluid accumulation inside the lungs, known as cardiac pulmonary edema, is one of the main early symptoms of congestive heart failure (CHF). That accumulation causes significant changes in the electrical properties of the lung tissues, which in turn can be detected using microwave techniques. To that end, the design and implementation of an automated ultrahigh-frequency microwave-based system for CHF detection and monitoring is presented. The hardware of the system consists of a wideband folded antenna attached to a fully automated vertical scanning platform, compact microwave transceiver, and laptop. The system includes software in the form of operational control, signal processing, and visualizing algorithms. To detect CHF, the system is designed to vertically scan the rear side of the human torso in a monostatic radar approach. The collected data from the scanning is then visualized in the time domain using the inverse Fourier transform. These images show the intensity of the reflected signals from different parts of the torso. Using a differential based detection technique, a threshold is defined to differentiate between healthy and unhealthy cases. This paper includes details of developing the automated platform, designing the antenna with the required properties imposed by the system, developing a signal processing algorithm, and introducing differential detection technique besides investigating miscellaneous probable CHF cases

Method and apparatus for monitoring an organ of a patient

An implanted device for an organ of a patient including a housing. The device includes a detector having electrodes that have a varying distance over time between them which produces a detector signal based on electrical signals derived from the organ. The device includes a signal processor disposed in the housing in communication with the detector which determines admittance from the detector signal based on the varying distance over time between the electrodes. The device includes a drive circuit disposed in the housing to cause the electrodes to generate emitted electrical signals. A method for monitoring a patient's organ.Board of Regents, University of Texas Syste

Bioimpedance as a predictor of survival in renal failure and associated comorbidities.

Background: Renal failure requiring dialysis is associated with a high mortality. One of the contributing causes is overhydration. Overhydration can be assessed by bioimpedance analysis (BIA)– the non-invasive electrical measure of small current through the tissues that estimates the proportion of fluid that is intracellular water (ICW, typically muscle which is healthy) and extracellular (ECW, which in excess causes tissue oedema and is potentially dangerous). Several studies indicate that a extracellular water to total body water (TBW) ratio is associated with increased risk of death in dialysis patients but it is not clear if this is independent of other risk factors for death, namely comorbidity. Aims and objectives: To establish the prognostic value of BIA in the prediction of survival on dialysis in the context of other known predictors of survival or hospitalisation. With further analysis of the applicability of the same scenario to heart failure patients. Methodology: To conduct a systematic review using a standardised approach including a prespecified research question, search terms and criteria for study inclusion. With independent selection for inclusion in the study and quality appraisal by multiple authors with different backgrounds and experience. Results: 2701 studies identified by literature search, plus an additional 4 through reference checking. 38 papers included in final analysis, 4 of which were regarding heart failure cohorts. Analysis of the research shows that BIA is an independent predictor of mortality. Conclusion: BIA shown to be an independent predictor of mortality in dialysis patients, further research needed to extrapolate to heart failure (HF) populations