Edema index may predict Cardiorespiratory Fitness in Heart Failure Patients With Diabetes: Study
Aaccording to research findings, edema index was determined to be a good predictor index in cardiorespiratory fitness in heart failure patients,specially with reduced ejection fraction and type 2 diabetes mellitus.Bioelectric impedance analysis-measured edema index (EI) is a feasible, non-invasive technique for measuring fluid overload. EI is an independent predictor...
Aaccording to research findings, edema index was determined to be a good predictor index in cardiorespiratory fitness in heart failure patients,specially with reduced ejection fraction and type 2 diabetes mellitus.
Bioelectric impedance analysis-measured edema index (EI) is a feasible, non-invasive technique for measuring fluid overload. EI is an independent predictor of cardiorespiratory fitness in heart failure patients with reduced ejection fraction and type 2 diabetes mellitus. One of the prominent features of heart failure (HF) is fluid overload, which is difficult to measure in a noninvasive manner. However, the edema index (EI), a surrogate for extracellular volume status, can be estimated with bioelectrical impedance analysis.
In this cross‐sectional analysis, Researchers investigated whether EI predicts cardiorespiratory fitness (CRF) in patients with HF with reduced ejection fraction (EF) and type 2 diabetes mellitus, and hypothesized that greater EI would predict reduced CRF.
For the study design, researchers prospectively collected data on stable patients with symptomatic HF with reduced EF (New York Heart Association class II–III; left ventricular EF <50%) and type 2 diabetes mellitus. We measured peak oxygen consumption (VO2), a measure of CRF, and exercise time, a measure of functional capacity, during maximal cardiopulmonary exercise testing.3 EI was measured with single‐frequency bioelectrical impedance analysis (RJL System, Inc, Clinton Township, MI) by dividing the percentage of extracellular water by total body water. Subjects underwent venipuncture to measure serum creatinine, CRP (C‐reactive protein), hemoglobin, NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide), and sodium. Health‐related quality of life was assessed using the Minnesota Living With HF Questionnaire.
Data analysis revealed the following facts.
- EI was positively associated with BMI (ρ=0.388; P=0.001) and negatively associated with age, serum creatinine, and hemoglobin (ρ=−0.239, P=0.040; ρ=−0.296, P=0.011; and ρ=−0.329, P=0.004, respectively).
- EI was inversely associated with peak VO2 and exercise time (Figure). EI was also inversely associated with the ventilatory anaerobic threshold (ρ=−0.309; P=0.008) and O2 pulse (ρ=−0.308; P=0.008), but not significantly with minute ventilation/carbon dioxide production slope (ρ=−0.091; P=0.440) nor respiratory exchange ratio (ρ=−0.009; P=0.941).
- Increased BMI, NT‐proBNP, and Minnesota Living With HF Questionnaire score, and lower hemoglobin levels, were also associated with lower peak VO2 (ρ=−0.353, P=0.002; ρ=−0.318, P=0.006; ρ=−0.248, P=0.035; and ρ=0.288, P=0.014, respectively.
- Men demonstrated a higher median EI than their female counterparts (p = .013) and Black participants had significantly greater EI than White participants (p = .020).
"In this study, we showed for the first time that bioelectrical impedance analysis–measured EI, which reflects increased extracellular volume, serves as an independent predictor of CRF in patients with HF with reduced EF and type 2 diabetes mellitus. Greater EI was also associated with worse functional capacity (ie, exercise time)."the team concluded.
For full article follow the link; https://doi.org/10.1161/JAHA.120.018631
Primary source: Journal of the American Heart Association