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Physiopathologic correlates of intrathoracic impedance in chronic heart failure patients

Luca Tomasi1, Gabriele Zanotto, Luisa Zanolla

  • 1Divisione Clinicizzata di Cardiologia, Azienda Ospedaliera Istituti Ospitalieri di Verona, Verona, Italy. lucatomasi1@gmail.com

Pacing and Clinical Electrophysiology : PACE
|November 25, 2010
PubMed

Insights

Intrathoracic impedance monitoring shows promise for early detection of heart failure (HF) decompensation. A decrease in impedance correlates with increased NT-proBNP and altered mitral E-wave deceleration time, indicating worsening HF.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Device Technology

Background:

  • Elevated NT-proBNP and abnormal Doppler transmitral flow patterns signal decompensated heart failure (HF).
  • Intrathoracic impedance monitoring, available in some implantable defibrillators, reflects lung water content and potential HF deterioration.

Purpose of the Study:

  • To evaluate the correlation between intrathoracic impedance and NT-proBNP levels.
  • To assess the relationship between intrathoracic impedance and echo-Doppler transmitral flow indexes in HF patients.

Main Methods:

  • 111 heart failure patients on optimal medical therapy were studied across six Italian centers.
  • Data including device diagnostics, NT-proBNP, Doppler transmitral flow, and clinical status were collected at regular and unscheduled visits.
  • Intrathoracic impedance, NT-proBNP, and mitral E-wave deceleration time (DtE) were analyzed over a median follow-up of 413 days.

Main Results:

  • Intrathoracic impedance significantly correlated with NT-proBNP (P=0.013) and DtE (P=0.017).
  • During confirmed HF alert events, NT-proBNP levels were significantly higher, and impedance was significantly lower compared to non-alert events.
  • No significant difference in DtE was observed between alert and non-alert events.

Conclusions:

  • Decreased intrathoracic impedance is inversely correlated with NT-proBNP and directly correlated with DtE.
  • Intrathoracic impedance monitoring offers a physiologically sound method for early identification of HF decompensation.
  • This monitoring approach may enhance proactive management of heart failure.
Abstract

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