| Publication Type |
Journal Article |
| Authors |
Illapha Cuba Gyllensten, Alberto G. Bonomi, Kevin M. Goode, Harald Reiter, Joerg Habetha, Oliver Amft, John GF Cleland |
| Title |
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 |
| Abstract |
Background: 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. Objective: In this study, we review previously proposed predictive algorithms using body weight and noninvasive transthoracic bio-impedance (NITTI) to predict HF decompensations. Methods: 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). Results: 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. Conclusions: NITTI measurements decrease before decompensations, and combined with trend algorithms, improve the detection of HF decompensation over current guideline rules; however, many alerts are not associated with clinically overt decompensation. |
| Publication |
JMIR Medical Informatics |
| Volume |
4 |
| Issue |
1 |
| Pages |
e3 |
| Date |
March 2016 |
| Language |
en |
| DOI |
10.2196/medinform.4842 |
| Short Title |
Early Indication of Decompensated Heart Failure in Patients on Home-Telemonitoring |
| URL |
Publisher's website |
| Accessed |
2016-02-19T21:35:21Z |
| Library Catalog |
medinform.jmir.org |
| Rights |
Unless stated otherwise, all articles are open-access distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work... |
| Full Text |
PDF |
