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

James P Curtain; Atefeh Talebi; Alasdair McIntosh; Alex McConnachie; Joanne O'Donnell; Paul Welsh; Joanna Osmanska; Matthew M Y Lee; Piotr Sonecki; Tony Akl; Joohyun Seo; Venugopal Gopinathan; Jed Hurwitz; Srikanth Thiagarajan; Stephen Pettit; Paul R Kalra; Rajan K Patel; Patrick B Mark; Ninian N Lang; John J V McMurray; Mark C Petrie; Roy S Gardner; Pardeep S Jhund

doi:10.1002/ejhf.3290

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

Eur J Heart Fail. 2024 May 13. doi: 10.1002/ejhf.3290. Online ahead of print.

Authors

James P Curtain^{1

2}, Atefeh Talebi¹, Alasdair McIntosh³, Alex McConnachie³, Joanne O'Donnell³, Paul Welsh¹, Joanna Osmanska¹, Matthew M Y Lee¹, Piotr Sonecki⁴, Tony Akl⁵, Joohyun Seo⁵, Venugopal Gopinathan⁵, Jed Hurwitz⁶, Srikanth Thiagarajan⁵, Stephen Pettit⁷, Paul R Kalra⁸, Rajan K Patel⁹, Patrick B Mark¹, Ninian N Lang¹, John J V McMurray¹, Mark C Petrie¹, Roy S Gardner^{1

10}, Pardeep S Jhund¹

Affiliations

¹ BHF Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.
² St James Hospital, Dublin, Ireland.
³ Robertson Centre for Biostatistics, School of Health and Wellbeing, University of Glasgow, Glasgow, UK.
⁴ Department of Cardiology, Queen Elizabeth University Hospital, Glasgow, UK.
⁵ Analog Devices Inc, Wilmington, MA, USA.
⁶ Analog Devices Ltd, Edinburgh, UK.
⁷ Transplant Unit, Royal Papworth Hospital, Cambridge, UK.
⁸ Department of Cardiology, Portsmouth Hospitals University NHS Trust, Portsmouth, UK.
⁹ Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK.
¹⁰ Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Clydebank, UK.

PMID: 38741283
DOI: 10.1002/ejhf.3290

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 [r_sp] = -0.64, p = 0.002) and change in device S3 (r_sp = -0.53, p = 0.014). In the haemodialysis cohort (n = 21), B-lines and TI were strongly correlated before (r_sp = -0.71, p < 0.001) and after (r_sp = -0.77, p < 0.001) dialysis. Volume of fluid removed by dialysis was correlated with change in device TI (r_sp = 0.49, p = 0.024). In the RHC cohort (n = 20), PCWP measured at one time point and device S3 were not significantly correlated (r_sp = 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.

Keywords: Congestion; Haemodialysis; Heart failure; Monitoring; Right heart catheterization.

Grants and funding

Analog Devices