Value of electrical cardiometry in the diagnosis of heart failure in adults

Wei Xue; Du Xinyue; Liu Long; Jiang Qiuyue; Deng Guolan

doi:10.13406/j.cnki.cyxb.003831

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Value of electrical cardiometry in the diagnosis of heart failure in adults

Clinical research | 更新时间：2025-10-22

- Value of electrical cardiometry in the diagnosis of heart failure in adults
- Journal of Chongqing Medical University Vol. 50, Issue 7, Pages: 977-982(2025)
- 作者机构：
  
  1.重庆医科大学附属第一医院心血管内科，重庆 400016
  2.重庆市合川区人民医院放射科，重庆 401533
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003831
  CLC： R541.6
- Received：26 December 2024，
  
  Revised：2023-03-23，
  
  Accepted：31 March 2025，
  
  Published：28 July 2025
- 稿件说明：
移动端阅览
韦雪,杜新月,刘龙,等.电子心力测量法对成人心力衰竭的诊断价值研究[J].重庆医科大学学报,2025,50(7):977-982.

Wei Xue,Du Xinyue,Liu Long,et al.Value of electrical cardiometry in the diagnosis of heart failure in adults[J].Journal of Chongqing Medical University,2025,50(7):977-982.
韦雪,杜新月,刘龙,等.电子心力测量法对成人心力衰竭的诊断价值研究[J].重庆医科大学学报,2025,50(7):977-982. DOI： 10.13406/j.cnki.cyxb.003831.

Wei Xue,Du Xinyue,Liu Long,et al.Value of electrical cardiometry in the diagnosis of heart failure in adults[J].Journal of Chongqing Medical University,2025,50(7):977-982. DOI： 10.13406/j.cnki.cyxb.003831.

摘要

目的

探讨无创血流动力学检测技术中的电子心力测量（electrical cardiometry，EC）法对成人心力衰竭（heart failure，HF）的诊断价值。

方法

选择2022年9月至2024年5月重庆医科大学附属第一医院心血管内科住院成人患者进行前瞻性研究，将临床诊断为HF的患者纳入HF组，临床排除HF的患者纳入对照组。比较2组EC法测定的每搏输出变异（stroke volume variation，SVV）、收缩时间比例（systolic time ratio，STR）、预射血前期（pre-ejection period，PEP）、心肌收缩指数（contractility，ICON）、心肌收缩指数变异（ICON Variation，VIC）、左心室射血时间（left ventricle ejection time，LVET）、左心室射血分数（left ventricular ejection fraction，LVEF）及一般临床资料。采用前进法构建多因素logistic回归模型分析HF的相关因素。进一步绘制EC法测定的血流动力学指标诊断HF的受试者工作特征（receiver operating characteristic，ROC）曲线，计算曲线下面积（area under the curve，AUC）。

结果

共纳入239例，其中HF组126例，对照组113例。HF组SVV、STR、PEP、VIC、年龄高于对照组，ICON、LVET、LVEF低于对照组（

0.001）。采用前进法构建多因素logistic回归模型结果显示，STR（

=1.199，95%CI=1.110~1.294，

0.001）、VIC（

=1.176，95%CI=1.090~1.269，

0.001）、年龄（

=1.068，95%CI=1.010~1.128，

0.05）与HF呈正相关。ICON（

=0.968，95%CI=0.941~0.996，

0.05）、LVEF（

=0.854，95%CI=0.798~0.913，

0.001）与HF呈负相关。ROC曲线显示STR、VIC、ICON诊断HF的AUC分别为0.887（95%CI=0.848~0.927）、0.891（95%CI=0.851~0.932）、0.718（95%CI=0.654~0.782）；最佳临界值分别为37.5%、19.5%、49.3；灵敏度依次为91.3%、73.8%、50.0%，特异度依次为61.4%、93.8%、86.7%。其中，STR联合VIC诊断HF的AUC为0.940（95%CI=0.912~0.967），灵敏度为83.3%，特异度为91.2%。

结论

EC法可有效评估成人患者的心功能状态，STR联合VIC对于诊断HF有一定的临床价值。

Abstract

Objective

To investigate the value of electrical cardiometry（EC），a noninvasive hemodynamic testing technique，in the diagnosis of heart failure（HF） in adults.

Methods

A prospective study was conducted among the adult patients who were hospitalized in Department of Cardiology，The First Affiliated Hospital of Chongqing Medical University，from September 2022 to May 2024，and the patients who were diagnosed with HF were enrolled as HF group，while those who were excluded from the clinical diagnosis of HF were enrolled as control group. The two groups were compared in terms of general clinical data and related parameters measured by EC，including stroke volume variation（SVV），systolic time ratio（STR），pre-ejection period（PEP），index of contractility（ICON），ICON variation（VIC），left ventricular ejection time（LVET），and left ventricular ejection fraction（LVEF）. A multivariate logistic regression model established by the forward method was used to investigate the factors associated with HF. The receiver operating characteristic （ROC） curve was plotted for the hemodynamic parameters measured by EC in the diagnosis of HF，and the area under the ROC curve （AUC） was calculated.

Results

A total of 239 patients were enrolled，with 126 in the HF group and 113 in the control group. Compared with the control group，the HF group had significantly higher SVV，STR，PEP，VIC，and age and significantly lower ICON，LVET，and LVEF（all

0.001）. The multivariate logistic regression model established by the forward method showed that STR （odds ratio［

］=1.199，95%CI=1.110-1.294，

0.001），VIC（

=1.176，95%CI=1.090-1.269，

0.001），and age（

=1.068，95%CI=1.010-1.128，

0.05） were positively correlated with HF，and ICON（

=0.968，95%CI=0.941-0.996，

0.05） and LVEF（

=0.854，95%CI=0.798-0.913，

0.001） were negatively correlated with HF. The ROC curve analysis showed that STR，VIC，and ICON had an AUC of 0.887（95%CI=0.848-0.927），0.891（95%CI=0.851-0.932），and 0.718 （95%CI=0.654-0.782），respectively，in the diagnosis of HF，with an optimal cut-off value of 37.5%，19.5%，and 49.3，respectively，a sensitivity of 91.3%，73.8%，and 50.0%，respectively，and a specificity of 61.4%，93.8%，and 86.7%，respectively. Among these indicators，STR combined with VIC had an AUC of 0.940（95%CI=0.912-0.967） in the diagnosis of HF，with a sensitivity of 83.3% and a specificity of 91.2%.

Conclusion

The EC method can effectively assess the cardiac functional status of adult patients，and STR combined with VIC has some clinical value for the diagnosis of heart failure.

关键词

Keywords

references

王　华，刘宇佳，杨杰孚 . 心力衰竭流行病学 [J ] . 临床心血管病杂志， 2023 ， 39 （ 4 ）： 243 - 247 ．

Wang H ， Liu YJ ， Yang JF . Epidemiology of heart failure [J ] . J Clin Cardiol ， 2023 ， 39 （ 4 ）： 243 - 247 ．

王　宙，周　琳，刘洋，等 . 慢性心力衰竭的流行病学研究现状及其防治研究进展 [J ] . 中国循证心血管医学杂志， 2019 ， 11 （ 8 ）： 1022 - 1024 ．

Wang Z ， Zhou L ， Liu Y ， et al . Epidemiology study status and research progress in prevention and treatment of chronic heart failure [J ] . Chin J Evid Based Cardiovasc Med ， 2019 ， 11 （ 8 ）： 1022 - 1024 ．

Heidenreich PA ， Bozkurt B ， Aguilar D ， et al . 2022 AHA/ACC/HFSA guideline for the management of heart failure：executive summary：a report of the American college of cardiology/American heart association joint committee on clinical practice guidelines [J ] . Circulation ， 2022 ， 145 （ 18 ）： e876 - e894 ．

张　芃 . 心力衰竭相关的血清标志物的初步筛选及与心室重构相关性的研究 [D ] . 北京：北京协和医学院， 2010 ．

Zhang P . Preliminary screening of serum markers related to heart failure and its correlation with ventricular remodeling [D ] . Beijing ： Peking Union Medical College ， 2010 ．

王卓清，李永豪，郭元芳，等 . 心功能不同时期患者的无创血流动力学检测分析 [J ] . 军事医学， 2017 ， 41 （ 8 ）： 675 - 679 ．

Wang ZQ ， Li YH ， Guo YF ， et al . Analysis of noninvasive hemodynamics in patients with cardiac disfunction during different periods [J ] . Mil Med Sci ， 2017 ， 41 （ 8 ）： 675 - 679 ．

Sumbel L ， Annamalai MR ， Wats A ， et al . Noninvasive cardiac output monitoring using electrical cardiometry and outcomes in critically ill children [J ] . J Pediatr Intensive Care ， 2020 ， 11 （ 2 ）： 114 - 119 ．

Osypka M . An introduction to electrical cardiometry [J ] . Electrical Cardiometry ， 2009 ， 49 （ 6 ）： 1 - 10 .

Kemp CD ， Conte JV . The pathophysiology of heart failure [J ] . Cardiovasc Pathol ， 2012 ， 21 （ 5 ）： 365 - 371 ．

Anjan VY ， Loftus TM ， Burke MA ， et al . Prevalence，clinical phenotype，and outcomes associated with normal B-type natriuretic peptide levels in heart failure with preserved ejection fraction [J ] . Am J Cardiol ， 2012 ， 110 （ 6 ）： 870 - 876 ．

Dhar S ， Pressman GS ， Subramanian S ， et al . Natriuretic peptides and heart failure in the patient with chronic kidney disease：a review of current evidence [J ] . Postgrad Med J ， 2009 ， 85 （ 1004 ）： 299 - 302 ．

Buckley LF ， Canada JM ， Del Buono MG ， et al . Low NT-proBNP levels in overweight and obese patients do not rule out a diagnosis of heart failure with preserved ejection fraction [J ] . ESC Heart Fail ， 2018 ， 5 （ 2 ）： 372 - 378 ．

Berthiaume LR ， Peets AD ， Schmidt U ， et al . Time series analysis of use patterns for common invasive technologies in critically ill patients [J ] . J Crit Care ， 2009 ， 24 （ 3 ）： 471 ．

Bajorat J ， Hofmockel R ， Vagts DA ， et al . Comparison of invasive and less-invasive techniques of cardiac output measurement under different haemodynamic conditions in a pig model [J ] . Eur J Anaesthesiol ， 2006 ， 23 （ 1 ）： 23 - 30 ．

Costachescu T ， Denault A ， Guimond JG ， et al . The hemodynamically unstable patient in the intensive care unit：hemodynamic vs . transesophageal echocardiographic monitoring [J ] . Crit Care Med ， 2002 ， 30 （ 6 ）： 1214 - 1223 ．

Wake PJ ， Ali M ， Carroll J ， et al . Clinical and echocardiographic diagnoses disagree in patients with unexplained hemodynamic instability after cardiac surgery [J ] . Can J Anesth ， 2001 ， 48 （ 8 ）： 778 - 783 ．

Mansouri S ， Alhadidi T ， Chabchoub S ， et al . Impedance cardiography：recent applications and developments [J ] . Biomedicalresearch ， 2018 ， 29 （ 19 ）： 3542 - 3552 ．

Keren HN ， Burkhoff D ， Squara P . Evaluation of a noninvasive continuous cardiac output monitoring system based on thoracic bioreactance [J ] . Am J Physiol Heart Circ Physiol ， 2007 ， 293 （ 1 ）： 583 - 589 ．

Velmahos GC ， Wo CC ， Demetriades D ， et al . Early continuous noninvasive haemodynamic monitoring after severe blunt trauma [J ] . Injury ， 1999 ， 30 （ 3 ）： 209 - 214 ．

Shoemaker WC ， Belzberg H ， Wo CC ， et al . Multicenter study of noninvasive monitoring systems as alternatives to invasive monitoring of acutely ill emergency patients [J ] . Chest ， 1998 ， 114 （ 6 ）： 1643 - 1652 ．

Rao SS ， Lalitha AV ， Reddy M ， et al . Electrocardiometry for hemodynamic categorization and assessment of fluid responsiveness in pediatric septic shock：a pilot observational study [J ] . Indian J Crit Care Med ， 2021 ， 25 （ 2 ）： 185 - 192 ．

Zhu GJ ， Zhang K ， Fu YX ， et al . Accuracy assessment of noninvasive cardiac output monitoring in the hemodynamic monitoring in critically ill patients [J ] . Ann Palliat Med ， 2020 ， 9 （ 5 ）： 3506 - 3512 ．

Trinkmann F ， Berger M ， Michels JD ， et al . Influence of electrode positioning on accuracy and reproducibility of electrical velocimetry cardiac output measurements [J ] . Physiol Meas ， 2016 ， 37 （ 9 ）： 1422 - 1435 ．

Suehiro K ， Joosten A ， Murphy LS ， et al . Accuracy and precision of minimally-invasive cardiac output monitoring in children：a systematic review and meta-analysis [J ] . J Clin Monit Comput ， 2016 ， 30 （ 5 ）： 603 - 620 ．

崔雅倩 . 无创心排血量监测对急性心肌梗死患者心力衰竭预警作用的探讨 [D ] . 广州：广州医科大学， 2023 ．

Cui YQ . Discussion on the early warning effect of noninvasive cardiac output monitoring on heart failure in patients with acute myocardial infarction [D ] . Guangzhou ： Guangzhou Medical University ， 2023 ．

Castellanos LR ， Bhalla V ， Isakson S ， et al . B-type natriuretic peptide and impedance cardiography at the time of routine echocardiography predict subsequent heart failure events [J ] . J Card Fail ， 2009 ， 15 （ 1 ）： 41 - 47 ．

Bhalla V ， Isakson S ， Bhalla MA ， et al . Diagnostic ability of B-type natriuretic peptide and impedance cardiography：testing to identify left ventricular dysfunction in hypertensive patients [J ] . Am J Hypertens ， 2005 ， 18 （ 2 Pt 2 ）： 73 - 81 ．

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