Heart failure & cardiomyopathiesCohort study
Residual congestion at discharge assessed by bioelectrical impedance and its prognostic value in acute heart failure: a multi-centre, prospective registry study
- multi-centre registry database
- prospective registry study
Authors' conclusion
The EI and PA measured at discharge independently predicted short-term WHFs in patients with AHF. The suggested thresholds for identifying patients at high-risk of residual congestion were EI ≥ 0.4 and PA < 4.5°. As a non-invasive and accessible modality, BIA holds promise as a complementary tool to established biomarkers for evaluating congestion at discharge.
Study context
- Population
- Patients with acute heart failure (AHF), with oedema index (EI) and phase angle (PA) measured by bioelectrical impedance analysis (BIA) at discharge360 (60%) male, median age 72.1 years
- Participants
- 600 patients
- Exposure
- high-risk BIA group compared with normal BIA group
Main finding
As reported in the abstract
WHF (composite of heart failure (HF) readmission and all-cause mortality) · Within 180 days
patients experienced WHFs
63 patients (11%)
Observational data: associations, not effects.
Further findings
| Outcome | Values | Estimate | P value | |
|---|---|---|---|---|
| EI and PA, univariate association with WHF · 90 and 180 days — EI vs normal BIA · 90 days, univariate | OR 1.83 (95% CI 1.43–2.35) | all P < .01 | ||
| EI and PA, univariate association with WHF · 90 and 180 days — EI vs normal BIA · 180 days, univariate | OR 1.76 (95% CI 1.44–2.14) | all P < .01 | ||
| EI and PA, univariate association with WHF · 90 and 180 days — PA vs normal BIA · 90 days, univariate | OR 0.93 (95% CI 0.90–0.96) | all P < .01 | ||
| EI and PA, univariate association with WHF · 90 and 180 days — PA vs normal BIA · 180 days, univariate | OR 0.94 (95% CI 0.91–0.96) | all P < .01 | ||
| Increased EI and decreased PA, independent association with WHFs · 90 and 180 days — Increased EI vs normal BIA · 90 days | aHR 1.71 (CI 1.26–2.31) | all P < .01 | ||
| Increased EI and decreased PA, independent association with WHFs · 90 and 180 days — Increased EI vs normal BIA · 180 days | aHR 1.64 (CI 1.30–2.07) | all P < .01 | ||
| Increased EI and decreased PA, independent association with WHFs · 90 and 180 days — decreased PA vs normal BIA · 90 days | aHR 0.91 (CI 0.86–0.96) | all P < .01 | ||
| Increased EI and decreased PA, independent association with WHFs · 90 and 180 days — decreased PA vs normal BIA · 180 days | aHR 0.92 (CI 0.89–0.97) | all P < .01 | ||
| WHFs, high-risk vs normal BIA group · 90 and 180 days — high-risk BIA group vs normal BIA · 90 days | aHR 6.79 (CI 1.71–26.93) | all P < .05 | ||
| WHFs, high-risk vs normal BIA group · 90 and 180 days — high-risk BIA group vs normal BIA · 180 days | aHR 3.43 (CI 1.41–8.32) | all P < .05 | ||
| 0.050.21520Ratio (log scale) |
| Outcome | Values | Estimate | P value |
|---|---|---|---|
| Prognostic thresholds for unfavourable outcomes (ROC analysis) | EI ≥ 0.4 predictive value 75% · P P < .01 · sensitivity 83% · specificity 56% · PA < 4.5° predictive value 71% · P P < .01 · sensitivity 81% · specificity 54% |
Original publication
Residual congestion at discharge assessed by bioelectrical impedance and its prognostic value in acute heart failure: a multi-centre, prospective registry study. ESC Heart Fail. Published 8 January 2026. doi:10.1093/eschf/xvaf019
Summarised from the published abstract; every number is checked against it