Control of water in the organism of elderly patients with severe chronic heart failure based on bioelectrical impedance analysis

Introduction. Heart failure (HF) is defined as an abnormality of the cardiac structure and/or function resulting in clinical symptoms (dyspnoea) and signs (edema), poor quality of life and shortened survival [1]. Currently, the correlations between heart failure with reduced ejection fraction (EF) (HFrEF) and Bioelectrical impedance analysis (BIA) have been only scantly investigated. Aim. The aim of this study is the evaluation of the possible role of Bioelectrical impedance analysis in patients with severe chronic heart failure. Materials and Methods. We evaluated 30 elderly patients: 22 were males (mean age 77 ± 8 years) and 8 females (mean age 60 ± 10 years) with HFrEF at baseline electrocardiograph evaluation. All patients were classified as New York Heart Association (NYHA) class III at baseline and provided an informed consent. The treatment with angiotensin-converting enzyme — inhibitors or angiotensin receptor blockers was interrupted and all patients were switched to sacubitril/valsartan 24/26 mg bid. Results. At the end of the observation period, therapy with sacubitril/valsartan was associated with improved redistribution of body water and extracellular mass (19,4 ± 3,0 at baseline vs 18,4 ± 2,6 Kg/m at 1 month; p = 0,001) and body weight reduction (81 ± 8 vs 78 ± 8 Kg; p = 0,002). Overall, this therapy resulted in a prompt (1 month) amelioration in the distribution of body water and decreased body weight, as well as improved clinical outcomes (dyspnoea) at physical examination. Conclusion. In this small case series, we investigated the correlation between sacubitril/valsartan and body water modification in elderly patients with HFrEF. Our preliminary data show that Bioelectrical impedance analysis could be a new effective approach in the evaluation and follow-up of elderly patients with chronic heart failure and reduced ejection fraction