TY - JOUR
T1 - Congestion and nutrition as determinants of bioelectrical phase angle in heart failure
AU - Scicchitano, P.
AU - Ciccone, M.M.
AU - Passantino, A.
AU - Valle, R.
AU - De Palo, M.
AU - Sasanelli, P.
AU - Sanasi, M.
AU - Piscopo, A.
AU - Guida, P.
AU - Caldarola, P.
AU - Massari, F.
N1 - Export Date: 7 December 2020
PY - 2020
Y1 - 2020
N2 - Background: The whole-body bioelectrical phase-angle (PhA) is emerging as a new tool in stratifying prognosis in patients with both acute (AHF) and chronic heart failure (CHF). Objective: To evaluate the determinants of PhA in HF patients. Methods: We analyzed data from 900 patients with AHF or CHF (mean age: 76±10 years, 54% AHF). Clinical, serum biochemical, echocardiographic and bioelectrical measurements were collected from all of patients. PhA was quantified in degrees. Congestion was assessed by a multiparametric approach, including the presence of peripheral edema, brain natriuretic peptides (BNP) plasma levels, blood urea nitrogen to creatinine ratio (BUN/Cr), and relative plasma volume status (PVS) calculated by Kaplan-Hakim's formula. Geriatric Nutritional Risk Index (GNRI) was adopted as indicator for nutritional status. Results: At univariate analysis, PhA was significantly lower in females, in patients with peripheral edema, and AHF. PhA significantly correlates age, BNP, PVS, BUN/Cr, and GNRI. At multivariate analysis, congestion biomarkers emerged as the major determinant of PhA as they explained the 34% of data variability, while age, GNRI, and gender only explained 6%, 0.5%, and 0.5%, respectively (adjusted R2 = 0.41). In particular, PVS (regression of coefficient B=−0.17) explained the 20% of PhA variability, while peripheral congestion (B=−0.27) and BNP (B=−0.15) contributed to 10% and 2%, respectively. Conclusions: The main determinant of bioelectrical PhA in patients with HF is congestion and PVS in particular, while nutritional status has marginal impact. © 2020 Elsevier Inc.
AB - Background: The whole-body bioelectrical phase-angle (PhA) is emerging as a new tool in stratifying prognosis in patients with both acute (AHF) and chronic heart failure (CHF). Objective: To evaluate the determinants of PhA in HF patients. Methods: We analyzed data from 900 patients with AHF or CHF (mean age: 76±10 years, 54% AHF). Clinical, serum biochemical, echocardiographic and bioelectrical measurements were collected from all of patients. PhA was quantified in degrees. Congestion was assessed by a multiparametric approach, including the presence of peripheral edema, brain natriuretic peptides (BNP) plasma levels, blood urea nitrogen to creatinine ratio (BUN/Cr), and relative plasma volume status (PVS) calculated by Kaplan-Hakim's formula. Geriatric Nutritional Risk Index (GNRI) was adopted as indicator for nutritional status. Results: At univariate analysis, PhA was significantly lower in females, in patients with peripheral edema, and AHF. PhA significantly correlates age, BNP, PVS, BUN/Cr, and GNRI. At multivariate analysis, congestion biomarkers emerged as the major determinant of PhA as they explained the 34% of data variability, while age, GNRI, and gender only explained 6%, 0.5%, and 0.5%, respectively (adjusted R2 = 0.41). In particular, PVS (regression of coefficient B=−0.17) explained the 20% of PhA variability, while peripheral congestion (B=−0.27) and BNP (B=−0.15) contributed to 10% and 2%, respectively. Conclusions: The main determinant of bioelectrical PhA in patients with HF is congestion and PVS in particular, while nutritional status has marginal impact. © 2020 Elsevier Inc.
U2 - 10.1016/j.hrtlng.2020.07.007
DO - 10.1016/j.hrtlng.2020.07.007
M3 - Article
VL - 49
SP - 724
EP - 728
JO - Heart and Lung: Journal of Acute and Critical Care
JF - Heart and Lung: Journal of Acute and Critical Care
SN - 0147-9563
IS - 6
ER -