Abstract
Aims: To improve telemonitoring strategies in heart failure patients, there is a need for novel non-obtrusive sensors that monitor parameters closely related to intracardiac filling pressures. This proof-of-concept study aims to evaluate the responsiveness of cardiac kinetic energy (KE) measured with the Kinocardiograph (KCG), consisting of a seismocardiographic (SCG) sensor and a ballistocardiographic (BCG) sensor, during treatment of patients with acute decompensated heart failure. Methods and results: Eleven patients with acute decompensated heart failure who were hospitalized for treatment with intravenous diuretics received daily KCG measurements. The KCG measurements were compared with the diameter of the inferior vena cava (IVC) and body weight. Follow-up stopped at discharge, that is, in the recompensated state. Median (interquartile range) weight and IVC diameter decreased significantly after diuretic treatment [weight 74.5 (67.6–98.7) to 73.3 (66.7–95.6) kg, P = 0.003; IVC diameter 2.47 (2.33–2.99) to 1.78 (1.65–2.47) cm, P = 0.03]. In contrast with BCG measurements, significant changes in median KE measured with SCG were observed during the passive filling phase of the diastole [SGG: 0.48 (0.39–0.60) to 0.69 (0.56–0.84), P = 0.026; BCG: 0.68 (0.46–0.73) to 0.68 (0.59–0.82), P = 0.062], the active filling phase of the diastole [SCG: 0.38 (0.30–0.61) to 0.31 (0.09–0.47), P = 0.016; BCG: 0.29 (0.17–0.39) to 0.26 (0.20–0.34), P = 0.248], and the ratio between the passive and active filling phases [SCG: 2.76 (1.68–5.30) to 5.02 (3.13–10.17), P = 0.006; BCG: 5.87 (3.57–7.55) to 5.27 (3.95–9.43), P = 0.790]. The correlations between changes in KE during the passive and active filling phases, using SCG, and changes in weight or IVC were non-significant. Systolic KE did not show significant changes. Conclusion: KE measured with the KCG using SCG is highly responsive to changes in fluid status. Future research is needed to confirm its accuracy in a larger study population and specifically its application for detection of clinical deterioration in the home-environment.
| Original language | English |
|---|---|
| Pages (from-to) | 3446-3453 |
| Number of pages | 8 |
| Journal | ESC Heart Failure |
| Volume | 10 |
| Issue number | 6 |
| Early online date | 14 Sept 2023 |
| DOIs | |
| Publication status | Published - Dec 2023 |
Funding
This research received no specific grant from any funding agency. C.H., H.K., P.F.M. and A.H. contributed to the concept and design of the study. C.H., M.v.L. and I.d.L. contributed to the acquisition of data. I.d.L. performed the data analysis. P.B. performed part of the kinocardiograph data analysis. All authors contributed to the interpretation of the data. C.H. and I.d.L. drafted the manuscript, except for the part ‘KCG signal processing’, which was drafted by A.H. All authors critically revised the manuscript. All gave final approval and agreed to be accountable for all aspects of work ensuring integrity and accuracy.
Keywords
- Ballistocardiography
- Heart failure
- Kinetic energy
- Seismocardiography
- Telemonitoring
- Heart
- Heart Failure/diagnosis
- Diuretics/therapeutic use
- Diastole
- Humans
- Systole