• Bashar A W Pandhita, Nduka C Okwose, Aaron Koshy, Óscar G Fernández, Noelia B Cruz, Christopher Eggett, Lazar Velicki, Dejana Popovic, Guy A MacGowan, and Djordje G Jakovljevic.
• Cardiovascular Research, Clinical and Translational and Biosciences Research Institutes, Faculty of Medical Sciences, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.
• J. Cardiothorac. Vasc. Anesth. 2021 Jun 1; 35 (6): 1776-1781.

ObjectivesThe aim of the present study was to assess the validity and trending ability of the bioreactance method in estimating cardiac output at rest and in response to stress in advanced heart failure patients and heart transplant candidates.DesignThis was a prospective single-center study.SettingThis study was conducted at the heart transplant center at the Freeman Hospital, Newcastle upon Tyne, UK.ParticipantsEighteen patients with advanced chronic heart failure due to reduced left ventricular ejection fraction (19 ± 7%), and peak oxygen consumption 12.3 ± 3.9 mL/kg/min.InterventionsParticipants underwent right heart catheterization using the Swan-Ganz catheter.Measurements And Main ResultsCardiac output was measured simultaneously using thermodilution and bioreactance at rest and during active straight leg raise test to volitional exertion. There was no significant difference in cardiac index values obtained by the thermodilution and bioreactance methods (2.26 ± 0.59 v 2.38 ± 0.50 L/min, p > 0.05) at rest and peak straight leg raise test (2.92 ± 0.77 v 3.01 ± 0.66 L/min, p > 0.05). In response to active leg raise test, thermodilution cardiac output increased by 22% and bioreactance by 21%. There was also a strong relationship between cardiac outputs from both methods at rest (r = 0.88, p < 0.01) and peak straight leg raise test (r = 0.92, p < 0.01). Cartesian plot analysis showed good trending ability of bioreactance compared with thermodilution (concordance rate = 93%) CONCLUSIONS: `Cardiac output measured by the bioreactance method is comparable to that from the thermodilution method. Bioreactance method may be used in clinical practice to assess hemodynamics and improve management of advanced heart failure patients undergoing heart transplant assessment.Copyright © 2020 Elsevier Inc. All rights reserved.

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