Abstract：
Using bio-impedance to deduce some hemodynamic parameters combined with some short-term ECG temporal dispersion intervals, and measuring myocardial depolarization, intraventricular conduction, and repolarization. A total of 65 in-hospital patients (M/F:35/30) were enrolled, 39 with HFrEF and 26 HFpEF, in New York Heart Association (NYHA) class IV. Stroke volume (SVI), cardiac indexes (CI), left ventricular ejection fraction (LVEFBIO), end diastolic volume (LV-EDV), and other systolic and diastolic parameters were noninvasively obtained at enrollment and at hospital discharge. At the same time, QR, QRS, QT, ST, Tpeak-Tend (Te) interval mean, and standard deviation (SD) from 5 min ECG recordings were obtained. At baseline, HFrEF patients reported significantly lower SVI (p < 0.05), CI (p < 0.05), and LVEF (p < 0.001) than HFpEF patients; moreover, HFrEF patients also showed increased LV-EDV (p < 0.05), QR, QRS, QT, ST, and Te means (p < 0.05) and standard deviations (p < 0.05) in comparison to HFpEF subjects. Multivariable logistic regression analysis reported a significant correlation between hospital mortality and Te mean (odds ratio: 1.03, 95% confidence limit: 1.01−1.06, p: 0.01). Fifty-seven percent of patients were considered responders to optimal medical therapy and, at discharge, they had significantly reduced NT-proBNP, (p < 0.001), heart rate (p < 0.05), and TeSD (p < 0.001). LVEF, obtained by transthoracic echocardiography, and LVEFBIO were significantly related (r: 0.781, p < 0.001), but these two parameters showed a low agreement limit. Noninvasive hemodynamic and ECG-derived parameters were useful to highlight the difference between HFrEF and HFpEF and between responders and nonresponders to the optimal medical therapy. Short-period bioimpedance and electrocardiographic data should be deeply evaluated to determine possible advantages in the therapeutic and prognostic approach in severe CHF.
摘要：
使用生物阻抗推导一些血液动力学参数，并结合一些短期ECG时间离散间隔，测量心肌去极化，脑室内传导,和复极化。共纳入65例住院患者（M/F：35/30），39与HFrEF和26HFpEF，纽约心脏协会（NYHA）四级。每搏输出量(SVI),心脏指数（CI），左心室射血分数(LVEFBIO),舒张末期容积(LV-EDV),以及其他收缩压和舒张压参数均在纳入时和出院时非侵入性获得.同时,QR，QRS,QT,ST,Tpeak-Tend(Te)间隔平均值，和5分钟心电图记录的标准偏差（SD）。在基线,HFrEF患者报告SVI显着降低（p<0.05），CI(p<0.05)，LVEF(p<0.001)高于HFpEF患者；此外，HFrEF患者还显示LV-EDV升高(p<0.05),QR，QRS,QT,ST,与HFpEF受试者相比，Te平均值（p＆lt;0.05）和标准偏差（p＆lt;0.05）。多变量逻辑回归分析报告了医院死亡率与Te平均值之间的显着相关性（比值比：1.03，95％置信限：1.01-1.06，p：0.01）。57%的患者被认为是最佳药物治疗的应答者，在放电时，他们显著降低了NT-proBNP，(p<0.001)，心率(p<0.05),和TeSD(p<0.001)。LVEF,通过经胸超声心动图获得，与LVEFBIO显著相关(r：0.781，p<0.001)，但这两个参数显示出较低的一致性极限。无创血流动力学和ECG衍生参数可用于突出HFrEF和HFpEF之间以及对最佳药物治疗的响应者和无响应者之间的差异。应深入评估短期生物阻抗和心电图数据，以确定严重CHF治疗和预后方法的可能优势。
