Measuring congestion with a non-invasive monitoring device in heart failure and haemodialysis: CONGEST-HF

Curtain, J. P. et al. (2024) Measuring congestion with a non-invasive monitoring device in heart failure and haemodialysis: CONGEST-HF. European Journal of Heart Failure, (doi: 10.1002/ejhf.3290) (PMID:38741283) (Early Online Publication)

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Abstract

Aims We examined the effectiveness of a novel cardiopulmonary management wearable sensor (worn for less than 5 mins) at measuring congestion and correlated the device findings with established clinical measures of congestion. Methods and results We enrolled three cohorts of patients: (1) patients with heart failure (HF) receiving intravenous diuretics in hospital; (2) patients established on haemodialysis, and (3) HF patients undergoing right heart catheterization (RHC). The primary outcomes in the respective cohorts were a Spearman correlation between (1) change in weight and change in thoracic impedance (TI) (from enrolment, 24 h after admission to discharge) in patients hospitalized for HF; (2) lung ultrasound B-lines and volume removed during dialysis with device measured TI, and (3) pulmonary capillary wedge pressure (PCWP) and sub-acoustic diastolic, third heart sound (S3) in the patients undergoing RHC. A total of 66 patients were enrolled. In HF patients (n = 25), change in weight was correlated with both change in device TI (Spearman correlation [rsp] = −0.64, p = 0.002) and change in device S3 (rsp = −0.53, p = 0.014). In the haemodialysis cohort (n = 21), B-lines and TI were strongly correlated before (rsp = −0.71, p < 0.001) and after (rsp = −0.77, p < 0.001) dialysis. Volume of fluid removed by dialysis was correlated with change in device TI (rsp = 0.49, p = 0.024). In the RHC cohort (n = 20), PCWP measured at one time point and device S3 were not significantly correlated (rsp = 0.230, p = 0.204). There were no device-related adverse events. Conclusions A non-invasive device was able to detect changes in congestion in patients with HF receiving decongestion therapy and patients having fluid removed at haemodialysis. The cardiopulmonary management device, which measures multiple parameters, is a potentially useful tool to monitor patients with HF to prevent hospitalizations.

Item Type:Articles
Additional Information:The CONGEST-HF study was funded by Analog Devices Inc. AT, MCP, JJVM and PSJ are supported by a British Heart Foundation Centre of Research Excellence Grant RE/18/6/34217 and the Vera Melrose Heart Failure Research Fund.
Keywords:Heart failure, haemodialysis, right heart catheterisation, congestion, monitoring.
Status:Early Online Publication
Refereed:Yes
Glasgow Author(s) Enlighten ID:McConnachie, Professor Alex and Lee, Matthew and Talebi, Dr Atefeh and Mark, Professor Patrick and Curtain, Dr James and Jhund, Professor Pardeep and Welsh, Professor Paul and McIntosh, Dr Alasdair and Petrie, Professor Mark and Gardner, Professor Roy and Lang, Professor Ninian and Sonecki, Dr Piotr and Osmanska, Dr Joanna and McMurray, Professor John
Authors: Curtain, J. P., Talebi, A., McIntosh, A., McConnachie, A., O’Donnell, J., Welsh, P., Osmanska, J., Lee, M. M.Y., Sonecki, P., Akl, T., Seo, J., Gopinathan, V., Hurwitz, J., Thiagarajan, S., Pettit, S., Kalra, P. R., Patel, R. K., Mark, P. B., Lang, N. N., McMurray, J. J.V., Petrie, M. C., Gardner, R. S., and Jhund, P. S.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:European Journal of Heart Failure
Publisher:Wiley
ISSN:1388-9842
ISSN (Online):1879-0844
Published Online:13 May 2024
Copyright Holders:Copyright: © 2024 The Authors
First Published:First published in European Journal of Heart Failure 2024
Publisher Policy:Reproduced under a Creative Commons licence

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
303944BHF Centre of ExcellenceColin BerryBritish Heart Foundation (BHF)RE/18/6/34217SCMH - Cardiovascular & Metabolic Health