Decreased intrathoracic impedance associated with OptiVol alert can diagnose increased B-type natriuretic peptide – MOMOTARO (monitoring and management of OptiVol alert to reduce heart failure hospitalization) study –

MOMOTARO

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Ambulatory measurement of intrathoracic impedance (ITI) with an implanted device may detect increases in pulmonary fluid retention early, but the clinical utility of this method is not well established. The goal of this study was to test whether conventional ITI-derived parameters can diagnose fluid retention that may cause early stage heart failure (HF). Methods and Results: HF patients implanted with high-energy devices with OptiVol (Medtronic) monitoring were enrolled in this study. Patients were monitored remotely. At both baseline and OptiVol alert, patients were assessed on standard examinations, including analysis of serum brain natriuretic peptide (BNP). From April 2010 to August 2011, 195 patients from 12 institutes were enrolled. There were 154 primary OptiVol alert events. BNP level at the alerts was not significantly different from that at baseline. Given that ITI was inversely correlated with log BNP, we added a criterion specifying that the OptiVol alert is triggered only when ITI decreases by ≥4% from baseline. This change improved the diagnostic potential of increase in BNP at OptiVol alert (sensitivity, 75%; specificity, 88%). Conclusions: BNP increase could not be identified based on OptiVol alert. Decrease in ITI ≥4% compared with baseline, in addition to the alert, however, may be a useful marker for the likelihood of HF (Clinical trial info: UMIN000003351).

Original languageEnglish
Pages (from-to)1315-1322
Number of pages8
JournalCirculation Journal
Volume79
Issue number6
DOIs
Publication statusPublished - May 11 2015

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Brain Natriuretic Peptide
Electric Impedance
Hospitalization
Heart Failure
Equipment and Supplies
Clinical Trials
Lung
Serum

Keywords

  • Brain natriuretic peptide
  • Heart failure
  • Intrathoracic impedance
  • OptiVol alert
  • Remote monitoring

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{5f9c9859d0554425b31be8046e4b21c6,
title = "Decreased intrathoracic impedance associated with OptiVol alert can diagnose increased B-type natriuretic peptide – MOMOTARO (monitoring and management of OptiVol alert to reduce heart failure hospitalization) study –",
abstract = "Background: Ambulatory measurement of intrathoracic impedance (ITI) with an implanted device may detect increases in pulmonary fluid retention early, but the clinical utility of this method is not well established. The goal of this study was to test whether conventional ITI-derived parameters can diagnose fluid retention that may cause early stage heart failure (HF). Methods and Results: HF patients implanted with high-energy devices with OptiVol (Medtronic) monitoring were enrolled in this study. Patients were monitored remotely. At both baseline and OptiVol alert, patients were assessed on standard examinations, including analysis of serum brain natriuretic peptide (BNP). From April 2010 to August 2011, 195 patients from 12 institutes were enrolled. There were 154 primary OptiVol alert events. BNP level at the alerts was not significantly different from that at baseline. Given that ITI was inversely correlated with log BNP, we added a criterion specifying that the OptiVol alert is triggered only when ITI decreases by ≥4{\%} from baseline. This change improved the diagnostic potential of increase in BNP at OptiVol alert (sensitivity, 75{\%}; specificity, 88{\%}). Conclusions: BNP increase could not be identified based on OptiVol alert. Decrease in ITI ≥4{\%} compared with baseline, in addition to the alert, however, may be a useful marker for the likelihood of HF (Clinical trial info: UMIN000003351).",
keywords = "Brain natriuretic peptide, Heart failure, Intrathoracic impedance, OptiVol alert, Remote monitoring",
author = "MOMOTARO and Nobuhiro Nishii and Motoki Kubo and Yoji Okamoto and Satoki Fujii and Atsuyuki Watanabe and Yuko Toyama and Tadakatsu Yamada and Masayuki Doi and Hiroshi Morita and Hiroshi Itoh",
year = "2015",
month = "5",
day = "11",
doi = "10.1253/circj.CJ-15-0076",
language = "English",
volume = "79",
pages = "1315--1322",
journal = "Circulation Journal",
issn = "1346-9843",
publisher = "Japanese Circulation Society",
number = "6",

}

TY - JOUR

T1 - Decreased intrathoracic impedance associated with OptiVol alert can diagnose increased B-type natriuretic peptide – MOMOTARO (monitoring and management of OptiVol alert to reduce heart failure hospitalization) study –

AU - MOMOTARO

AU - Nishii, Nobuhiro

AU - Kubo, Motoki

AU - Okamoto, Yoji

AU - Fujii, Satoki

AU - Watanabe, Atsuyuki

AU - Toyama, Yuko

AU - Yamada, Tadakatsu

AU - Doi, Masayuki

AU - Morita, Hiroshi

AU - Itoh, Hiroshi

PY - 2015/5/11

Y1 - 2015/5/11

N2 - Background: Ambulatory measurement of intrathoracic impedance (ITI) with an implanted device may detect increases in pulmonary fluid retention early, but the clinical utility of this method is not well established. The goal of this study was to test whether conventional ITI-derived parameters can diagnose fluid retention that may cause early stage heart failure (HF). Methods and Results: HF patients implanted with high-energy devices with OptiVol (Medtronic) monitoring were enrolled in this study. Patients were monitored remotely. At both baseline and OptiVol alert, patients were assessed on standard examinations, including analysis of serum brain natriuretic peptide (BNP). From April 2010 to August 2011, 195 patients from 12 institutes were enrolled. There were 154 primary OptiVol alert events. BNP level at the alerts was not significantly different from that at baseline. Given that ITI was inversely correlated with log BNP, we added a criterion specifying that the OptiVol alert is triggered only when ITI decreases by ≥4% from baseline. This change improved the diagnostic potential of increase in BNP at OptiVol alert (sensitivity, 75%; specificity, 88%). Conclusions: BNP increase could not be identified based on OptiVol alert. Decrease in ITI ≥4% compared with baseline, in addition to the alert, however, may be a useful marker for the likelihood of HF (Clinical trial info: UMIN000003351).

AB - Background: Ambulatory measurement of intrathoracic impedance (ITI) with an implanted device may detect increases in pulmonary fluid retention early, but the clinical utility of this method is not well established. The goal of this study was to test whether conventional ITI-derived parameters can diagnose fluid retention that may cause early stage heart failure (HF). Methods and Results: HF patients implanted with high-energy devices with OptiVol (Medtronic) monitoring were enrolled in this study. Patients were monitored remotely. At both baseline and OptiVol alert, patients were assessed on standard examinations, including analysis of serum brain natriuretic peptide (BNP). From April 2010 to August 2011, 195 patients from 12 institutes were enrolled. There were 154 primary OptiVol alert events. BNP level at the alerts was not significantly different from that at baseline. Given that ITI was inversely correlated with log BNP, we added a criterion specifying that the OptiVol alert is triggered only when ITI decreases by ≥4% from baseline. This change improved the diagnostic potential of increase in BNP at OptiVol alert (sensitivity, 75%; specificity, 88%). Conclusions: BNP increase could not be identified based on OptiVol alert. Decrease in ITI ≥4% compared with baseline, in addition to the alert, however, may be a useful marker for the likelihood of HF (Clinical trial info: UMIN000003351).

KW - Brain natriuretic peptide

KW - Heart failure

KW - Intrathoracic impedance

KW - OptiVol alert

KW - Remote monitoring

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U2 - 10.1253/circj.CJ-15-0076

DO - 10.1253/circj.CJ-15-0076

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JO - Circulation Journal

JF - Circulation Journal

SN - 1346-9843

IS - 6

ER -