Non-Invasive Measurement of Hemodynamic Parameters via Whole-Body Impedance Cardiography Among Hospitalized Heart Failure Patients: An Effective Alternative to Invasive Right Heart Catheterization?

TL;DR

This study compares non-invasive whole-body impedance cardiography to invasive catheterization for measuring heart function in hospitalized heart failure patients.

Contribution

The study evaluates the accuracy of whole-body ICG as a non-invasive alternative to RHC in measuring hemodynamic parameters in heart failure patients.

Findings

Non-invasive CO and CI measurements showed no significant bias compared to RHC measurements.

Non-invasive TPR and PVR measurements showed significant bias compared to RHC measurements.

Whole-body ICG may be a reliable alternative for CO and CI but not for TPR and PVR.

Abstract

(1) Background: The measurement of hemodynamic parameters has proven to be crucial in the treatment of hospitalized heart failure patients, necessitating invasive measurement by right heart catheterization (RHC). The reliability of whole-body impedance cardiography (ICG) among this cohort has not been investigated to date; (2) Methods: The RHC and whole-body ICG examinations measured cardiac output (CO), the cardiac index (CI), total peripheral resistance (TPR), and pulmonary vascular resistance (PVR). To assess the accuracy of the whole-body ICG measurement, bias and precision were calculated as the mean difference and the twofold standard deviation between the average values of measurements; (3) Results: A total of 203 patients were analyzed. No significant bias was observed between the non-invasive CO and CI measurements when compared with the RHC measurements (−0.14 ± 2.56 L/min, p = 0.1; −0.09 ± 1.3 L/min/m2, p = 0.06), but a significant bias occurred in the measurement of non-invasive TPR and non-invasive PVR (−1243 ± 3510 dyn × s−1 × cm−5, p = 0.001; −121 ± 504 dyn × s−1 × cm−5, p < 0.001); (4) Conclusions: CO and CI can be measured with whole-body ICG among hospitalized CHF patients with acceptable accuracy. The reliability of measuring TPR and PVR should be further investigated.

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