ReviewAmerican heart journal plus : cardiology research and practice2026
Prognostic value of bioelectrical impedance analysis in heart failure: A systematic review of congestion assessment and clinical outcomes.
Review in American heart journal plus : cardiology research and practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Comment on "Prognostic value of bioelectrical impedance analysis in heart failure: A systematic review of congestion assessment and clinical outcomes".American heart journal plus : cardiology research and practice · 2026Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Congestion is a major driver of adverse outcomes in heart failure, yet its objective assessment in clinical practice remains challenging. Bioelectrical impedance analysis (BIA) offers a non-invasive evaluation of fluid distribution and cellular integrity. We conducted a systematic review in accordance with PRISMA 2020, searching PubMed/MEDLINE, Embase, Cochrane CENTRAL and Web of Science from database inception to 30 November 2025 for studies evaluating BIA-derived parameters and clinically relevant outcomes in adult patients with acute or chronic heart failure. Thirteen studies met the inclusion criteria; all were observational and most were single-centre. In acute heart failure, elevated extracellular water, abnormal impedance vectors and increased edema indices were associated with rehospitalization and mortality, particularly when congestion persisted at discharge, although in one cohort this association did not persist after adjustment for age and natriuretic peptide. In chronic heart failure, BIA detected subclinical fluid overload associated with worsening heart failure events and cardiovascular death. Among the studies reporting multivariable-adjusted hazard ratios, values for adverse outcomes ranged from 1.96 to 2.67. Lower phase angle was also associated with increased mortality, although phase angle reflects cellular integrity and nutritional status rather than congestion specifically. The evidence base is heterogeneous with respect to devices, parameters, cut-offs, timing of measurement and outcome definitions, and quantitative pooling was not appropriate; the review was not prospectively registered and small-study effects and selective publication cannot be excluded. BIA-derived parameters are associated with clinically relevant outcomes in heart failure and may complement conventional congestion assessment, but no interventional evidence currently supports BIA-guided management, which remains to be tested.
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Registered trials
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