Comparison of the prognostic value of Remote Dielectric Sensing and lung ultrasound in assessing the dynamics of congestion in ADHF
N Khutsishvili, F E Cabello Montoya, S E Korandji, S A Galochkin, V V Tolkacheva, I S Nazarov, T V Lobzhanidze, Z H D KobalavaAbstract
Background
Congestion is an important factor in the prognosis of patients with heart failure (HF). Multiparametric assessment with the remote dielectric sensing (ReDS) system and lung ultrasound (LUS) has become a highly informative and accessible diagnostic tool for evaluating prognosis in patients with HF.
Objectives
To evaluate how delta values from non-invasive studies such as ReDS and lung ultrasound correlates with prognosis.
Methods
A retrospective cohort study consecutively enrolled 88 patients with decompensated heart failure. ReDS and LUS was performed upon admission and discharge. According to the delta level, patients were divided into those with positive and negative dynamics. All patients were followed up once every 12 months. Adverse cardiovascular events were cardiogenic death and heart failure hospitalization.
Results
The mean age was 67±14 years, and 68% were male. On admission, left ventricular ejection fraction was 39%±15% and NT-proBNP was 1106 pg/L (Q1-Q3: 810-6396 pg/L). ReDS: 36,11%±6,98% upon admission, ReDS: 31,86%±6,11% upon discharge, LUS: 12 (9-17) B lines upon admission, LUS: 4 (1-10) B lines upon discharge At 12 months follow-up, comparing to LUS delta, ReDS delta showed a greater area under the ROC curve (AUC) for death and rehospitalization, (ReDS AUC= 0.79 vs LUS AUC= 0.66). Patients who had a positive dynamic by ReDS also presented positive dynamics by lung ultrasound (p: 0.020). Patients with negative ReDS dynamics at one year of observation showed more deaths and rehospitalizations according to the Kaplan-Meier Logrank test: X²: 14.94, p: 0.001, more significant than the negative dynamics of LUS Logrank test: X²: 5.50, p: 0.018.
Patients with negative ReDS dynamics showed higher risks of death and rehospitalization according to the Cox method, hazard ratios 5.6, 95% CI of Exp 1.90 to 16.56, p: 0.0019.
Conclusion
ReDS dynamic of congestion is a stronger and more independent predictor of cardiogenic death and rehospitalization risk compared to lung ultrasound in patients with decompensated heart failure.