Relationship Between Noninvasive Assessment of Lung Fluid Volume and Invasively Measured Cardiac Hemodynamics

N Uriel, G Sayer, T Imamura, D Rodgers, G Kim, J Raikhelkar, N Sarswat, S Kalantari, B Chung, A Nguyen, D Burkhoff, A Abbo
J Am Heart Assoc. 2018;7:e009175. DOI: 10.1161/JAHA.118.009175.)

Background-—Right heart catheterization is the gold standard in clinical practice for the assessment of cardiovascular hemodynamics, but it is an invasive procedure requiring expertise in both insertion and reading. Remote dielectric sensing (ReDS) is a noninvasive electromagnetic-based technology intended to quantify lung fluid content.

Methods and Results-—In this prospective single-center study, ReDS readings were obtained in supine position just before right heart catheterization procedure in patients with heart failure. Agreement between ReDS and pulmonary artery wedge pressure (PAWP) was analyzed. Of all, 139 patients with heart failure received hemodynamic assessment and ReDS measurement. A good correlation was found between ReDS and PAWP measurement (r=0.492, P<0.001). Receiver operating characteristic analysis of the ability to identify a PAWP ≥18 mm Hg resulted in a ReDS cutoff value of 34%, with an area under the curve of 0.848, a sensitivity of 90.7%, and a specificity of 77.1%. Overall, ReDS <34% carries a high negative predictive value of 94.9%.

Conclusions-—Lung fluid content, as measured by ReDS, correlates well with PAWP. The high sensitivity and specificity and especially the high negative predictive value make ReDS a reliable noninvasive tool at the point of care, to rule out elevated PAWP in patients with heart failure and to help with medical management of patients with heart failure. Further studies are warranted to compare this tool with existing tests and to relate the findings to the clinical outcomes.

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