ArticleESC heart failure2026
Bioimpedance-derived compartmental fluid status and prognosis in chronic heart failure.
Article in ESC heart failure, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionNovel bioimpedance analysis (BIA) devices may improve the precision of fluid overload assessment, potentially offering additional prognostic information beyond clinical parameters in patients with HF. This study aimed to evaluate the association between fluid overload indexes obtained with a novel bioelectrical impedance device (BioScan touch i8 IVF, MALTRON®) and the risk of cardiovascular events in ambulatory patients with HF.
methodsVolume excess was assessed using BioScan Touch i8 IVF (MALTRON), which differentiates fluid distribution across body compartments. Volume-excess variables (total, intravascular, and tissue) were analysed both as quartiles (Q) and as continuous measures. Their independent associations with the composite of all-cause death or worsening HF were adjusted for established prognostic markers, including a clinical congestion score (CCS) and N-terminal pro-B-type natriuretic peptide.
resultsAmong 386 ambulatory patients with stage C chronic HF, median total, intravascular, and tissue fluid excess were 1.3 L (Q1-Q3: 0.5, 2.3), 0.1 L (Q1-Q3: -0.1, 0.4), and 1.9 L (Q1-Q3: 1.1, 2.8), respectively. Total and tissue fluid excess had the strongest correlation with the CCS (Total fluid excess rho = 0.31; P < .001, tissue fluid excess rho = 0.33; P < .001). In adjusted analyses, patients in the highest quartile had significantly higher risk of the composite outcome compared with Q1: total fluid excess hazard ratio (HR) 2.11 [95% confidence interval (CI) 1.21-4.05, P = .010], intravascular fluid excess HR 2.16 (1.19-3.90, P = .011), and tissue fluid excess HR 2.81 (1.49-5.32, P = .001).
conclusionCompartment-specific estimates of fluid overload obtained with the BioScan Touch i8 IVF were independently associated with adverse outcomes in ambulatory patients with chronic HF, beyond NT-proBNP and clinical surrogates of congestion. These findings support the potential role of BIA-derived indexes, particularly tissue fluid excess, as complementary tools for risk stratification in this population.
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