Sizing and mending of appendicular muscle mass for hydration during the 12-lead electrocardiogram: True incidence of sarcopenia in heart failure.

Background: Our aim was to develop and evaluate a method for the measurement of muscle mass during the 12-channel electrocardiogram (ECG), to determine the incidence of sarcopenia in patients with overhydration and to correct it for congestion.

Methods: A 12-channel ECG that simultaneously provided multifrequency segmental impedance data was used to measure total body water (TBW), extracellular water (ECW), ECW/TBW ratio and appendicular muscle mass (AppMM), validated by whole-body dual-energy X-ray absorptiometry. The mean ECW/TBW ratio was 0.

Abdominal Aortic Aneurysm Detection in Bioelectrical Impedance Cardiovascular Screenings-A Pilot Study.

Screening and diagnosing abdominal aortic aneurysms (AAA) are currently dependent on imaging studies such as ultrasound or computed tomography angiography. All imaging studies offer distinct advantages but also suffer from inherent limitations such as examiner dependency or ionizing radiation. Bioelectrical impedance analysis has previously been investigated with respect to its use in the detection of several cardiovascular and renal pathologies.

Measurement of aortofemoral volume wave velocity during the routine 12-channel ECG: relation to age, physiological hemoglobin A 1C, triglycerides and SBP in healthy individuals.

Objective: Measurements of pulse wave velocity are generally thought to be too impractical for clinical routine. This study aimed to develop a method that can be performed during routine 12-channel ECG.

Methods: A 12-channel ECG simultaneously supplies arterial impedance plethysmographic signals from the extremities beside segmental multifrequency impedance measurements for obtaining body composition.

The Combyn™ ECG: Adding haemodynamic and fluid leads for the ECG. Part II: Prediction of total body water (TBW), extracellular fluid (ECF), ECF overload, fat mass (FM) and "dry" appendicular muscle mass (AppMM).

Simultaneous with a 12 channel ECG, body composition was analysed by segmental multi-frequency impedance analysis in 101 healthy subjects and in 118 patients with chronic heart failure (CHF, n= 40), chronic renal failure with haemodialysis (HD, n= 20), and miscellaneous internal diseases (n= 58). Whole body DXA and sodium bromide dilution were used as reference methods for total body water (TBW), extracellular fluid (ECF), appendicular muscle mass (AppMM) and fat mass (FM). Empirical prediction equations were developed in a randomized evaluation sample and then evaluated in unknowns.

Adding "hemodynamic and fluid leads" to the ECG. Part I: the electrical estimation of BNP, chronic heart failure (CHF) and extracellular fluid (ECF) accumulation.

Objectives: In primary care the diagnosis of CHF and ECF accumulation is no triviality. We aimed to predict plasma BNP, CHF and ECF accumulation with segmental impedance spectroscopy while using and extending the electrodes of the conventional electrocardiography.

Methods: Three combined multiple electrodes were added to the 15 lead ECG for segmental impedance spectroscopy and for measuring the maximal rate of segmental fluid volume change with heart action at the thorax and the legs.

A critical analysis of whole body bioimpedance spectroscopy (BIS) for the estimation of body compartments in health and disease.

Aim of the study was to assess the accuracy and precision of a BIS device and the relative contribution of BIS beyond the anthropometric parameters. The output of the Impedimed device (SFB7) and the relative contribution of height, weight, age, sex and resistance values at zero and infinite frequency (Rzero and Rinf respectively) to the prediction of total body water (TBWd, deuterium space), of extracellular fluid (ECFbr, sodium bromide space) and of fat mass (FMDXA) were assessed in 116 subjects (32 healthy subjects and 84 patients with disorders of body composition). Using a repeated randomization procedure, new equations for TBW, ECF and FM were derived.

Proto-dialytic cardiac function relates to intra-dialytic morbid events.

Background: Intra-dialytic morbid events (IDME) such as intra-dialytic hypotension (IDH) and muscle cramps frequently complicate haemodialysis (HD). Cardiac dysfunction is highly prevalent in HD patients. We investigated the relationship between proto-dialytic (i.

Prevalence of chronic kidney disease in patients with suspected sleep apnoea.

Background: Little is known about the epidemiology of chronic kidney disease (CKD) in patients with suspected sleep apnoea (SA).

Methods: Glomerular filtration rate (eGFR) was calculated in consecutive patients referred for full-night observed in-hospital polysomnography. SA was defined as the respiratory disturbance index (RDI) > 5.

Sympathetic reserve, serum potassium, and orthostatic intolerance after endurance exercise and implications for neurocardiogenic syncope.

Aims: To elucidate the mechanisms of orthostatic intolerance (OI) after endurance exercise which are incompletely understood.

Methods And Results: We investigated beat-to-beat haemodynamic and autonomic parameters in 51 male athletes during supine rest and after active standing the day before and 2 h after a marathon run. None of the subjects before the marathon [non-orthostatic intolerance (Non-OI)], but 14 after the marathon [orthostatic intolerance (OI)] exhibited with pre-syncope.

Determinants of fast marathon performance: low basal sympathetic drive, enhanced postcompetition vasodilatation and preserved cardiac performance after competition.

Objective: To test the hypothesis that enhanced postexercise vasodilatation is related to sympathetic drive to resistance vessels and to fast marathon performance.

Design: Prospective field study before and after running a marathon.

Participants: 51 healthy amateur runners who volunteered to participate.

Noninvasive measurement of cardiac output in hemodialysis patients by task force monitor: a comparison with the Transonic System.

Cardiovascular disease is the leading cause of morbidity and mortality in maintenance hemodialysis (MHD) patients. The Transonic (TRS; Transonic Systems, Ithaca, NY) device is frequently used for determination of cardiac output (CO) by an indicator dilution technique. The Task Force Monitor (TFM; CN Systems, Graz, Austria) has gained attention as noninvasive tool for continuous beat-to-beat assessment of cardiovascular variables, including CO by impedance cardiography.

Evaluation of treatment adherence in type 1 diabetes: a novel approach.

Background: Intensified insulin therapy requires outstanding compliance but no measure of therapy adherence has been agreed upon. The aim of the current study was to test the hypothesis that treatment adherence, as described by a novel multiple regression model, relates to glycosylated haemoglobin and hypoglycaemia frequency in type 1 diabetes. Furthermore, we sought to analyse the complex diurnal patterns of therapy adherence.

Continuous non-invasive blood pressure monitoring using concentrically interlocking control loops.

A new method and apparatus for non-disruptive blood pressure (BP) recording in the finger based on the vascular unloading technique is introduced. The instrument, in contrast to intermittent set point readjustments of the conventional vascular unloading technique, delivers BP without interruptions, thus refining the Penáz' principle. The method is based on concentrically interlocking control loops for correct long-term tracing of finger BP, including automatic set point adaptation, light control and separate inlet and outlet valves for electro-pneumatic control.

Haplotypes of the beta-2 adrenergic receptor associate with high diastolic blood pressure in the Caerphilly prospective study.

Objectives: Current evidence demonstrates that both genetic and environmental factors influence blood pressure. The sympathetic nervous system is a key player in blood pressure control and functional genetic variants of the beta-2 adrenergic receptor (B2AR) have been identified and implicated in the pathogenesis of hypertension. The present study aimed to determine the effects of common haplotypes of the B2AR gene upon blood pressure in the Caerphilly Prospective Study.

Multi-site-frequency electromechanocardiography for the prediction of ejection fraction and stroke volume in heart failure.

Background: Methods for stroke volume (SV) and ejection fraction (EF) measurements require the presence of qualified physicians and are not suited for continuous monitoring.

Aim: To develop an automated non-invasive method for the measurement and continuous monitoring of SV and EF.

Methods: We have designed a method for the measurement of EF and SV using multiple-site-impedance (z0) measurements, applying multiple frequencies of 5, 40 and 200 kHz whereby various segments of the human body, including volume changes within these segments, could be defined electrically.

Hemodynamic and autonomic changes induced by Ironman: prediction of competition time by blood pressure variability.

We hypothesized that the extreme endurance exercise of an Ironman competition would lead to long-standing hemodynamic and autonomic changes. We investigated also the possibility of predicting competition performance from baseline hemodynamic and autonomic parameters. We have investigated 27 male athletes before competition, 1 h after, and then for the following week after the competition.

[Arterial elasticity, arterial hypertension and antihypertensive therapy].

Semi-automated methods for pulse wave analysis enable the early diagnosis of changes in the elasticity of large and small blood vessels. Currently two methods are in routine use: a) The augmentation index and b) the compliance of the large and the small blood vessels (C1, C2). It has been shown that both measurements are able to predict cardiovascular mortality independent of other established risk factors.

Search for occult secondary osteoporosis: impact of identified possible risk factors on bone mineral density.

Objectives: To determine whether the use of more elaborate diagnostic tests can identify possible risk factors for secondary osteoporosis and to evaluate the impact of these possible risk factors on the severity of bone disease in the study population.

Design: Cross-sectional study.

Setting And Participants: We have investigated 377 subjects (285 females, 92 males) with osteoporosis (T-score less than -2.

Coronary anatomy predicts presence or absence of renal artery stenosis. A prospective study in patients undergoing cardiac catheterization for suspected coronary artery disease.

Aims: This study aimed to determine the prevalence of renal artery stenosis (RAS) and associated risk factors in patients undergoing cardiac catheterization for suspected coronary artery disease (CAD).

Methods: One hundred and seventy-seven consecutive patients (62 females) with a serum creatinine concentration <2.0mg.

Autonomic dysfunction and hemodynamics in vitamin B12 deficiency.

Orthostatic hypotension in patients with cobalamin (Cbl) deficiency has been reported previously in isolated cases but we are not aware of detailed systematic studies of hemodynamic and autonomic nervous system function in patients with cobalamin deficiency. We investigated hemodynamic and autonomic responses to 60 degrees passive head up tilt (HUT) in 21 patients with vitamin B12 deficiency, 21 healthy age-matched control subjects and 9 age-matched patients with diabetes mellitus (DM) and established diabetic neuropathy. To systematically assess hemodynamic and autonomic nervous system function, we performed measurements of heart rate, beat-to-beat systolic and diastolic blood pressure, stroke index, cardiac index, total peripheral resistance index, total power, low (LF) and high (HF) frequency oscillatory component of heart rate variability, LF/HF ratio and spontaneous baroreflex sensitivity.