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Non-Invasive Lung IMPEDANCE-Guided Preemptive Treatment in Chronic Heart Failure Patients: A Randomized Controlled Trial (IMPEDANCE-HF Trial)

Previous investigations have suggested that lung impedance (LI)-guided treatment reduces hospitalizations for acute heart failure (AHF). A single-blind 2-center trial was performed to evaluate this hypothesis ( ). The study population included 256 patients from 2 medical centers with chronic heart f... Full description

Journal Title: Journal of Cardiac Failure September 2016, Vol.22(9), pp.713-722
Main Author: Shochat, Michael Kleiner
Other Authors: Shotan, Avraham , Blondheim, David S , Kazatsker, Mark , Dahan, Iris , Asif, Aya , Rozenman, Yoseph , Kleiner, Ilia , Weinstein, Jean Marc , Frimerman, Aaron , Vasilenko, Lubov , Meisel, Simcha R
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: ISSN: 1071-9164 ; E-ISSN: 1532-8414 ; DOI: 10.1016/j.cardfail.2016.03.015
Link: https://www.sciencedirect.com/science/article/pii/S1071916416300082
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recordid: elsevier_sdoi_10_1016_j_cardfail_2016_03_015
title: Non-Invasive Lung IMPEDANCE-Guided Preemptive Treatment in Chronic Heart Failure Patients: A Randomized Controlled Trial (IMPEDANCE-HF Trial)
format: Article
creator:
  • Shochat, Michael Kleiner
  • Shotan, Avraham
  • Blondheim, David S
  • Kazatsker, Mark
  • Dahan, Iris
  • Asif, Aya
  • Rozenman, Yoseph
  • Kleiner, Ilia
  • Weinstein, Jean Marc
  • Frimerman, Aaron
  • Vasilenko, Lubov
  • Meisel, Simcha R
subjects:
  • Acute Heart Failure
  • Chronic Heart Failure
  • Monitoring Heart Failure
  • Lung Impedance
  • Medicine
ispartof: Journal of Cardiac Failure, September 2016, Vol.22(9), pp.713-722
description: Previous investigations have suggested that lung impedance (LI)-guided treatment reduces hospitalizations for acute heart failure (AHF). A single-blind 2-center trial was performed to evaluate this hypothesis ( ). The study population included 256 patients from 2 medical centers with chronic heart failure and left ventricular ejection fraction ≤35% in New York Heart Association class II-IV, who were admitted for AHF within 12 months before recruitment. Patients were randomized to a control group treated by clinical assessment and a monitored group whose therapy was also assisted by LI, and followed for at least 12 months. Noninvasive LI measurements were performed with a new high-sensitivity device. Patients, blinded to their assignment group, were scheduled for monthly visits in the outpatient clinics. The primary efficacy endpoint was AHF hospitalizations; the secondary endpoints were all-cause hospitalizations and mortality. There were 67 vs 158 AHF hospitalizations during the first year (  
language: eng
source:
identifier: ISSN: 1071-9164 ; E-ISSN: 1532-8414 ; DOI: 10.1016/j.cardfail.2016.03.015
fulltext: fulltext
issn:
  • 1071-9164
  • 10719164
  • 1532-8414
  • 15328414
url: Link


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titleNon-Invasive Lung IMPEDANCE-Guided Preemptive Treatment in Chronic Heart Failure Patients: A Randomized Controlled Trial (IMPEDANCE-HF Trial)
creatorShochat, Michael Kleiner ; Shotan, Avraham ; Blondheim, David S ; Kazatsker, Mark ; Dahan, Iris ; Asif, Aya ; Rozenman, Yoseph ; Kleiner, Ilia ; Weinstein, Jean Marc ; Frimerman, Aaron ; Vasilenko, Lubov ; Meisel, Simcha R
ispartofJournal of Cardiac Failure, September 2016, Vol.22(9), pp.713-722
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subjectAcute Heart Failure ; Chronic Heart Failure ; Monitoring Heart Failure ; Lung Impedance ; Medicine
descriptionPrevious investigations have suggested that lung impedance (LI)-guided treatment reduces hospitalizations for acute heart failure (AHF). A single-blind 2-center trial was performed to evaluate this hypothesis ( ). The study population included 256 patients from 2 medical centers with chronic heart failure and left ventricular ejection fraction ≤35% in New York Heart Association class II-IV, who were admitted for AHF within 12 months before recruitment. Patients were randomized to a control group treated by clinical assessment and a monitored group whose therapy was also assisted by LI, and followed for at least 12 months. Noninvasive LI measurements were performed with a new high-sensitivity device. Patients, blinded to their assignment group, were scheduled for monthly visits in the outpatient clinics. The primary efficacy endpoint was AHF hospitalizations; the secondary endpoints were all-cause hospitalizations and mortality. There were 67 vs 158 AHF hospitalizations during the first year (  < .001) and 211 vs 386 AHF hospitalizations (  < .001) during the entire follow-up among the monitored patients (48 ± 32 months) and control patients (39 ± 26 months,  = .01), respectively. During the follow-up, there were 42 and 59 deaths (hazard ratio 0.52, 95% confidence interval 0.35–0.78,  = .002) with 13 and 31 of them resulting from heart failure (hazard ratio 0.30, 95% confidence interval 0.15–0.58  < .001) in the monitored and control groups, respectively. The incidence of noncardiovascular death was similar. Our results seem to validate the concept that LI-guided preemptive treatment of chronic heart failure patients reduces hospitalizations for AHF as well as the incidence of heart failure, cardiovascular, and all-cause mortality.
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