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Published on: December 13, 2019
Comparing impedance cardiography and echocardiography in the assessment of reduced left ventricular systolic function
Elzbieta Kaszuba1, Sergej Scheel, Håkan Odeberg
1Blekinge Competence Centre, Wämö Centre, Karlskrona SE-371 81, Sweden. elzbieta.kaszuba@med.lu.se
Insights
Impedance cardiography (ICG) shows potential for assessing left ventricular function in heart failure patients. Three ICG parameters were significantly associated with ejection fraction, suggesting a role in diagnosis.
Area of Science:
- Cardiology and Cardiovascular Diagnostics
- Biomedical Engineering and Instrumentation
Background:
- Accurate diagnosis of chronic heart failure (CHF) is crucial for prognosis but challenging in primary care.
- Echocardiography is the gold standard for assessing left ventricular (LV) function but has limited accessibility.
- Impedance cardiography (ICG) offers a noninvasive, low-cost alternative for LV function assessment, performable by general practitioners.
Purpose of the Study:
- To investigate the association between hemodynamic parameters measured by ICG and ejection fraction (EF) determined by echocardiography.
- To evaluate ICG's utility in identifying reduced left ventricular systolic function in patients with chronic heart failure.
Main Methods:
- A non-interventional, observational study involving 36 chronic heart failure patients.
- Simultaneous examination using echocardiography and impedance cardiography (ICG).
- Statistical analysis included descriptive statistics and Kruskal-Wallis test (p<0.05 significance).
Main Results:
- Three ICG parameters—pre-ejection period, left ventricular ejection time, and systolic time ratio—showed significant association with echocardiography-derived ejection fraction.
- These findings differ from previous studies suggesting other ICG parameters for assessing LV systolic function.
Conclusions:
- The identified associations between specific ICG parameters and EF are novel.
- Current understanding of ICG hemodynamic parameters is insufficient for clinical adoption in describing LV systolic dysfunction.
- Further research is needed to validate and refine ICG's role in heart failure management.
Background:
An early and accurate diagnosis of chronic heart failure is a big challenge for a general practitioner. Assessment of left ventricular function is essential for the diagnosis of heart failure and the prognosis. A gold standard for identifying left ventricular function is echocardiography. Echocardiography requires input from specialized care and has a limited access in Swedish primary health care. Impedance cardiography (ICG) is a noninvasive and low-cost method of examination. The survey technique is simple and ICG measurement can be performed by a general practitioner. ICG has been suggested for assessment of left ventricular function in patients with heart failure. We aimed to study the association between hemodynamic parameters measured by ICG and the value of ejection fraction as a determinant of reduced left ventricular systolic function in echocardiography.
Methods:
A non-interventional, observational study conducted in the outpatients heart failure unit. Thirty-six patients with the diagnosis of chronic heart failure were simultaneously examined by echocardiography and ICG. Distribution of categorical variables was presented as numbers. Distribution of continuous variables was presented as a mean and 95% Confidence Interval. Kruskal-Wallis test was used to compare variables and show differences between the groups. A p-value of <0.05 was considered significant.
Results:
We found that three ICG parameters: pre-ejection fraction, left ventricular ejection time and systolic time ratio were significantly associated with ejection fraction measured by echocardiography.
Conclusions:
The association which we found between EF and ICG parameters was not reported in previous studies. We found no association between EF and ICG parameters which were suggested previously as the determinants of reduced left ventricular systolic function.The knowledge concerning explanation of hemodynamic parameters measured by ICG that is available nowadays is not sufficient to adopt the method in practice and use it to describe left ventricular systolic dysfunction.
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