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Related Concept Videos

Electrocardiogram01:29

Electrocardiogram

An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
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Related Experiment Video

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Evaluation of Hydration Status by Bioelectrical Impedance Vector Analysis in Patients with Ischemic Heart Disease Undergoing Exercise Stress Test
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Published on: September 22, 2023

Complementary cardiac functional assessment using systolic time intervals and bioelectrical impedance analysis.

Tomoaki Nishikawa1, Akinori Higaki2, Keisho Kurokawa1

  • 1Department of Cardiology, Pulmonology, Hypertension & Nephrology, Ehime University Graduate School of Medicine, Toon, Japan.

Open Heart
|June 8, 2026
PubMed
Summary

This study introduces a non-invasive method using bioelectrical impedance analysis (BIA) and pulse wave analysis (PWA) to assess heart failure haemodynamics. The new approach successfully predicted major adverse cardiovascular events (MACEs), offering a practical alternative to invasive methods.

Keywords:
AtherosclerosisEchocardiographyHEART FAILURERisk Factors

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Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Diagnostics

Background:

  • The Forrester classification is crucial for heart failure haemodynamics but requires invasive right heart catheterisation.
  • A non-invasive, reproducible alternative is needed for clinical application.
  • Bioelectrical impedance analysis (BIA) and pulse wave analysis (PWA) offer potential for non-invasive assessment.

Purpose of the Study:

  • To develop and validate a novel, non-invasive method for haemodynamic assessment in heart failure.
  • To integrate BIA and PWA for virtual Forrester profiling.
  • To assess the prognostic value of this non-invasive profiling for major adverse cardiovascular events (MACEs).

Main Methods:

  • Retrospective study of 558 heart failure patients (Jan 2020-Dec 2022).
  • Integration of PWA-derived systolic time intervals (STIs) and BIA-based fluid status (ECW/TBW).
  • Classification into four virtual Forrester profiles: Warm/Dry, Warm/Wet, Cold/Dry, Cold/Wet.
  • Primary endpoint: MACEs, analyzed using Kaplan-Meier survival analysis.

Main Results:

  • Patients were classified into the four virtual Forrester profiles.
  • Significant differences in MACE-free survival were observed among the profiles (log-rank p=0.01).
  • The 'Warm and Dry' profile demonstrated the most favourable prognosis, while 'Wet' and 'Cold' profiles were associated with poorer outcomes and specific clinical characteristics.

Conclusions:

  • Virtual Forrester profiling using BIA and PWA provides a practical, quantitative, and reproducible non-invasive framework for haemodynamic assessment in heart failure.
  • This method offers a valuable alternative to invasive assessments.
  • The profiling effectively stratifies patients based on MACE risk.