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Deora S, Choudhary R, Kaushik A, Singh S, Singh B, Kumar B. Noninvasive assessment of pulmonary congestion in heart failure: Need of the hour. Indian Heart J 2023; 75:224-228. [PMID: 37207829 PMCID: PMC10421985 DOI: 10.1016/j.ihj.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 04/25/2023] [Accepted: 05/15/2023] [Indexed: 05/21/2023] Open
Abstract
Early pulmonary congestion detection and surveillance in acute heart failure patients can prevent decompensation, minimize hospitalizations, and improve prognosis. In India, the warm and wet types of HF are still the most common types and residual congestion at discharge is still a significant concern. Thus, there is an urgent need for a reliable and sensitive means of identifying residual and subclinical congestion. Two such monitoring systems are available and approved by US FDA. These include CardioMEMS HF System (Abbott, Sylmar, California) and ReDS System (Sensible Medical Innovations, Ltd., Nanya, Israel). CardioMEMS is a wireless pressure-sensitive implantable device, while ReDS is a wearable noninvasive device for measurement of the lung fluid and hence direct detection of PC. This review discusses the role of noninvasive assessment in PC monitoring in patients with heart failure and its implications from an Indian perspective.
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Affiliation(s)
- Surender Deora
- All India Institute of Medical Sciences, Jodhpur, India.
| | | | - Atul Kaushik
- All India Institute of Medical Sciences, Jodhpur, India
| | | | | | - Barun Kumar
- All India Institute of Medical Sciences, Rishikesh, India
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Olesen ASO, Miger K, Fabricius-Bjerre A, Sandvang KD, Kjesbu IE, Sajadieh A, Høst N, Køber N, Wamberg J, Pedersen L, Schultz HHL, Abild-Nielsen AG, Wille MMW, Nielsen OW. Remote dielectric sensing to detect acute heart failure in patients with dyspnoea: a prospective observational study in the emergency department. EUROPEAN HEART JOURNAL OPEN 2022; 2:oeac073. [PMID: 36518260 PMCID: PMC9731402 DOI: 10.1093/ehjopen/oeac073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/26/2022] [Accepted: 10/29/2022] [Indexed: 06/17/2023]
Abstract
AIMS Remote dielectric sensing (ReDS) enables quick estimation of lung fluid content. To examine if ReDS is superior to other methods in detecting acute heart failure. METHODS AND RESULTS We included consecutive patients with dyspnoea from the emergency departments at Bispebjerg Hospital, Copenhagen, and performed ReDS, low-dose chest computed tomography (CT), echocardiogram, lung ultrasound, NT-Pro-brain natriuretic peptide (NT-proBNP), and a Boston score evaluation (chest X-ray and clinical signs). ReDS values >35% were used as a cut-off to diagnose pulmonary congestion. Acute heart failure was adjudicated by experts' review of health records but independently of ReDS values. Sub-analyses investigated ReDS in acute heart failure patients with congestion on CT. We included 97 patients within a median of 4.8 h from admittance: 25 patients (26%) were ReDS-positive and 39 (40%) had adjudicated acute heart failure (21 with and 18 without CT congestion). Heart failure patients had median ReDS 33%, left ventricular ejection fraction 48%, and NT-proBNP 2935 ng/L. A positive ReDS detected heart failure with 46% sensitivity, 88% specificity, and 71% accuracy. The AUC for ReDS was like the Boston score (P = 0.88) and the lung ultrasound score (P = 0.74). CT-congested heart failure patients had higher ReDS values than patients without heart failure (median 38 vs. 28%, P < 0.001). Heart failure patients without CT-congestion had ReDS values like patients without heart failure (mean 30 vs. 28%, P = 0.07). CONCLUSION ReDS detects acute heart failure similarly to the Boston score and lung ultrasound score, and ReDS primarily identifies the acute heart failure patients who have congestion on a chest CT.
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Affiliation(s)
| | - Kristina Miger
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark
| | - Andreas Fabricius-Bjerre
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark
| | - Kathrine Dyrsting Sandvang
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark
| | - Ingunn Eklo Kjesbu
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark
| | - Ahmad Sajadieh
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark
| | - Nis Høst
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark
| | - Nana Køber
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark
| | - Jesper Wamberg
- Department of Emergency Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark
| | - Lars Pedersen
- Department of Pulmonary Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark
| | - Hans Henrik Lawaetz Schultz
- Department of Pulmonary Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark
| | - Annemette Geilager Abild-Nielsen
- Department of Radiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark
| | | | - Olav Wendelboe Nielsen
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark
- Copenhagen Center for Translational Research, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Nielsine Nielsens Vej 4B, 2400 Copenhagen, Denmark
- Faculty of Health and Medical Sciences, Copenhagen University, Blegdamsvej 3, 2200 Copenhagen, Denmark
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Izumida T, Imamura T, Tanaka S, Kinugawa K. Experience with remote dielectric sensing (ReDS) for acute decompensated heart failure complicated by chronic obstructive pulmonary disease. J Cardiol Cases 2022; 26:386-389. [DOI: 10.1016/j.jccase.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/01/2022] [Accepted: 08/02/2022] [Indexed: 11/29/2022] Open
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