Nutrition 2007; 23(5):412-8
Réka Kegyes Bozó, dietitian; Zsuzsanna Lelovics, dietitian
Introduction:
- Heart failure is characterized by fluid disturbances. Changes in volume in the clinical practice are evaluated with fluid balance and weight measurements, but these do not reflect compartmental changes.
- Integrity of the cells can be characterized by the ratio of measured impedance values at 200 kHz and 5 kHz → Illness Marker (IM).
- Tracking IM over time → can be used as fluid distribution indicator.
- Multifrequency bioimpedance analysis may provide insight into the compartmental changes.
- Multifrequency bioimpedance can be used in altered fluid distribution.
Aims: To describe the body composition of heart failure patients to explore the potential clinical role of IM in heart failure.
Methods:
- Randomly selected in-patients, who gave informed consent.
- Body weight and height measured.
- Heart echocardiography done by experts.
- Bioimpedance measurements done with Bodystat Quadscan 4000.
Results:
- 35 patients were studied. Gender distribution: 57.1% men, 42.9% women, no significant difference according to functional status.
- Presence of Diabetes mellitus: 31.4%, hypertension 57.1%. No significant difference according to functional status (NYHA).
- Mean systolic function (EF) of the heart: 37%±13%
- Strong, significant correlation (r=0.51; p=0.002) between ECW/ICW and IM. Strong, significant correlation (r=0.56; p=0.0005) between ECW and heart functional status. Strong, significant correlation (r=0.56; p < 0.001) between ICW and functional status.
- Alterations in ECW and ICW compared to the normal values correlate strongly, negatively with functional status (r=0.55; p < 0005 and r=0.53; p < 0.001, respectively).
Conclusions:
- Patient population is obese.
- Bioimpedance measurements can distinguish between high fat content of the body and/or fluid overload.
- Significant differences are present according to the functional status in body water spaces and Illness Marker.
- There is a trend in the measured impedance data towards lower values in more severe cases. The significant difference detected in the difference between the measured impedance values reflects the clinical situation.
- Illness Marker and BIA can be used to track changes occuring during the course of the disease.
- The correlations between the body water spaces and IM and functional class show the potential clinical role of IM.
Download paper - Preliminary results for use of Illness Marker in heart failure patients