Impact of volume indices in bioelectrical impedance measurement on the assessment of cardiac function indices by echocardiography in hemodialysis patients

Cardiovascular events resulting from volume overload are a primary cause of mortality in hemodialysis patients. Bioelectrical impedance analysis (BIA) is significantly valuable for assessing the volume status of hemodialysis (HD) patients. In this article, we explore the correlation between the volume index measured by BIA and the cardiac function index assessed by echocardiography (ECG) in HD patients.
Between April and November 2018, we conducted a cross-sectional study involving randomly selected 126 maintenance HD patients. Comprehensive data on medical history and laboratory test results were collected. Subsequently, we investigated the correlation between volume indices measured by BIA and cardiac function parameters by ECG.
We discovered a significant correlation between the volume indices measured by BIA and various parameter of cardiac function. The Left Ventricular Hypertrophy (LVH) group exhibited higher levels of the percentage of Extracellular Water (ECW%) and the percentage of Total Body Water (TBW%) compared to the Non-LVH group. Extracellular Water (ECW) and Third Interstitial Fluid Volume (TSFV) were identified as independent risk factors for Left Ventricular Mass (LVM), and both demonstrated a high predictive value for LVM. ECW% emerged as an independent risk factor for the Left Ventricular Mass Index (LVMI), with a high predictive value for LVMI.
ECW and TSFV were found to be positively associated with cardiac function parameters in HD patients.

容量超负荷引发的心血管事件是血液透析（Hemodialysis, HD）患者死亡的首要诱因。生物电阻抗分析（Bioelectrical impedance analysis, BIA）在评估血液透析患者的容量状态方面具有重要临床价值。本文探讨了血液透析患者经生物电阻抗分析测得的容量指标与超声心动图（echocardiography, ECG）评估的心功能指标之间的相关性。
2018年4月至11月，本研究纳入经随机选取的126名维持性血液透析患者，开展横断面研究。研究人员收集了受试者的完整病史与实验室检测结果数据，随后分析了生物电阻抗分析测得的容量指标与超声心动图检测的心功能参数之间的相关性。
研究发现，生物电阻抗分析测得的容量指标与多项心功能参数存在显著相关性。与非左心室肥厚（Left Ventricular Hypertrophy, LVH）组相比，左心室肥厚组的细胞外水百分比（Extracellular Water percentage, ECW%）与总体水百分比（Total Body Water percentage, TBW%）水平更高。细胞外水（Extracellular Water, ECW）与第三间隙体液量（Third Interstitial Fluid Volume, TSFV）被确定为左心室质量（Left Ventricular Mass, LVM）的独立危险因素，且二者对左心室质量均具有较高的预测价值。细胞外水百分比（ECW%）则为左心室质量指数（Left Ventricular Mass Index, LVMI）的独立危险因素，对左心室质量指数具有较高的预测价值。
细胞外水与第三间隙体液量与血液透析患者的心功能参数呈正相关。