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dc.contributor.authorDarling, Chad E.
dc.contributor.authorDovancescu, Silviu
dc.contributor.authorSaczynski, Jane S.
dc.contributor.authorRiistama, Jarno
dc.contributor.authorSert Kuniyoshi, Fatima
dc.contributor.authorRock, Joseph
dc.contributor.authorMeyer, Theo E.
dc.contributor.authorMcManus, David D.
dc.date2022-08-11T08:11:02.000
dc.date.accessioned2022-08-23T17:29:47Z
dc.date.available2022-08-23T17:29:47Z
dc.date.issued2017-03-13
dc.date.submitted2020-05-14
dc.identifier.citation<p>Darling CE, Dovancescu S, Saczynski JS, Riistama J, Sert Kuniyoshi F, Rock J, Meyer TE, McManus DD. Bioimpedance-Based Heart Failure Deterioration Prediction Using a Prototype Fluid Accumulation Vest-Mobile Phone Dyad: An Observational Study. JMIR Cardio. 2017 Mar 13;1(1):e1. doi: 10.2196/cardio.6057. PMID: 31758769; PMCID: PMC6832026. <a href="https://doi.org/10.2196/cardio.6057">Link to article on publisher's site</a></p>
dc.identifier.issn2561-1011 (Linking)
dc.identifier.doi10.2196/cardio.6057
dc.identifier.pmid31758769
dc.identifier.urihttp://hdl.handle.net/20.500.14038/50396
dc.description.abstractBACKGROUND: Recurrent heart failure (HF) events are common in patients discharged after acute decompensated heart failure (ADHF). New patient-centered technologies are needed to aid in detecting HF decompensation. Transthoracic bioimpedance noninvasively measures pulmonary fluid retention. OBJECTIVE: The objectives of our study were to (1) determine whether transthoracic bioimpedance can be measured daily with a novel, noninvasive, wearable fluid accumulation vest (FAV) and transmitted using a mobile phone and (2) establish whether an automated algorithm analyzing daily thoracic bioimpedance values would predict recurrent HF events. METHODS: We prospectively enrolled patients admitted for ADHF. Participants were trained to use a FAV-mobile phone dyad and asked to transmit bioimpedance measurements for 45 consecutive days. We examined the performance of an algorithm analyzing changes in transthoracic bioimpedance as a predictor of HF events (HF readmission, diuretic uptitration) over a 75-day follow-up. RESULTS: We observed 64 HF events (18 HF readmissions and 46 diuretic uptitrations) in the 106 participants (67 years; 63.2%, 67/106, male; 48.1%, 51/106, with prior HF) who completed follow-up. History of HF was the only clinical or laboratory factor related to recurrent HF events (P=.04). Among study participants with sufficient FAV data (n=57), an algorithm analyzing thoracic bioimpedance showed 87% sensitivity (95% CI 82-92), 70% specificity (95% CI 68-72), and 72% accuracy (95% CI 70-74) for identifying recurrent HF events. CONCLUSIONS: Patients discharged after ADHF can measure and transmit daily transthoracic bioimpedance using a FAV-mobile phone dyad. Algorithms analyzing thoracic bioimpedance may help identify patients at risk for recurrent HF events after hospital discharge. Sert Kuniyoshi, Joseph Rock, Theo E Meyer, David D McManus. Originally published in JMIR Cardio (http://cardio.jmir.org), 13.03.2017.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=31758769&dopt=Abstract">Link to Article in PubMed</a></p>
dc.rightsCopyright © Chad Eric Darling, Silviu Dovancescu, Jane S Saczynski, Jarno Riistama, Fatima Sert Kuniyoshi, Joseph Rock, Theo E Meyer, David D McManus. Originally published in JMIR Cardio (http://cardio.jmir.org), 13.03.2017. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Cardio, is properly cited. The complete bibliographic information, a link to the original publication on http://cardio.jmir.org, as well as this copyright and license information must be included.
dc.subjectElectric impedance
dc.subjectheart failure
dc.subjectoutpatient monitoring
dc.subjecttelemedicine
dc.subjectUMCCTS funding
dc.subjectCardiology
dc.subjectCardiovascular Diseases
dc.subjectTelemedicine
dc.subjectTranslational Medical Research
dc.titleBioimpedance-Based Heart Failure Deterioration Prediction Using a Prototype Fluid Accumulation Vest-Mobile Phone Dyad: An Observational Study
dc.typeJournal Article
dc.source.journaltitleJMIR cardio
dc.source.volume1
dc.source.issue1
dc.identifier.legacyfulltexthttps://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1230&amp;context=umccts_pubs&amp;unstamped=1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/umccts_pubs/221
dc.identifier.contextkey17740871
refterms.dateFOA2022-08-23T17:29:47Z
html.description.abstract<p>BACKGROUND: Recurrent heart failure (HF) events are common in patients discharged after acute decompensated heart failure (ADHF). New patient-centered technologies are needed to aid in detecting HF decompensation. Transthoracic bioimpedance noninvasively measures pulmonary fluid retention.</p> <p>OBJECTIVE: The objectives of our study were to (1) determine whether transthoracic bioimpedance can be measured daily with a novel, noninvasive, wearable fluid accumulation vest (FAV) and transmitted using a mobile phone and (2) establish whether an automated algorithm analyzing daily thoracic bioimpedance values would predict recurrent HF events.</p> <p>METHODS: We prospectively enrolled patients admitted for ADHF. Participants were trained to use a FAV-mobile phone dyad and asked to transmit bioimpedance measurements for 45 consecutive days. We examined the performance of an algorithm analyzing changes in transthoracic bioimpedance as a predictor of HF events (HF readmission, diuretic uptitration) over a 75-day follow-up.</p> <p>RESULTS: We observed 64 HF events (18 HF readmissions and 46 diuretic uptitrations) in the 106 participants (67 years; 63.2%, 67/106, male; 48.1%, 51/106, with prior HF) who completed follow-up. History of HF was the only clinical or laboratory factor related to recurrent HF events (P=.04). Among study participants with sufficient FAV data (n=57), an algorithm analyzing thoracic bioimpedance showed 87% sensitivity (95% CI 82-92), 70% specificity (95% CI 68-72), and 72% accuracy (95% CI 70-74) for identifying recurrent HF events.</p> <p>CONCLUSIONS: Patients discharged after ADHF can measure and transmit daily transthoracic bioimpedance using a FAV-mobile phone dyad. Algorithms analyzing thoracic bioimpedance may help identify patients at risk for recurrent HF events after hospital discharge. Sert Kuniyoshi, Joseph Rock, Theo E Meyer, David D McManus. Originally published in JMIR Cardio (http://cardio.jmir.org), 13.03.2017.</p>
dc.identifier.submissionpathumccts_pubs/221
dc.contributor.departmentDepartment of Medicine, Division of Cardiovascular Medicine
dc.contributor.departmentDepartment of Emergency Medicine
dc.source.pagese1


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