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HOW INFERIOR VENA CAVA COLLAPSIBILITY INDEX FROM A NOVEL IMPLANTABLE SENSOR CORRELATES WITH ESTIMATED PLASMA VOLUME AND NT-PROBNP: A STUDY IN PATIENTS WITH CHRONIC HEART FAILURE

F. Málek, P. Doškář, F. Wetterling, Z. Marešová, V. Reddy, P. Neužil (Prague, Dublin, Ireland, New York, United States)

Topic: Heart failure

Type: Presentation - doctors, CCVRID 2023

Background:A new wireless implantable sensor can measure inferior vena cava (IVC) area and collapsibility index and was invented for remote monitoring in heart failure.
Study objective: To evaluate the relationship between IVC collapsibility, estimated plasma volume and NT-proBNP concentration in patients with chronic heart failure (CHF).

Patients and methods: A novel sensor was implanted in six CHF participants of the First in Human Clinical Investigation of the FIRE1 System in Heart Failure Patients (FUTURE-HF) in our cardiac center. The collapsibility index of the IVC was recorded on each clinic follow-up visit. Patient´s weight was recorded and hemoglobin, hematocrit and NT-proBNP were analyzed from the blood samples. An estimated plasma volume (ePV) was calculated by the Tetsuko formula. The correlation of parameters was evaluated by Pearson´s correlation coefficient.

Results: A total number of 58 measurments were analysed. The mean ePV was 7713.5 ml(median 7465 ml), the mean collapsibility index (CoI) was 46.5 % (median 42.2) and the mean NT-proBNP level was 1122.7 (median 988) ng/l. Statistically significant inverse correlation of collapsibility index (CoI) and estimated plasma volume was found (ePV and CoI, r = - 0.35, p = 0.0076). The correlation of NT-proBNP with CoI was not statistically significant (r = - 0.12, p = 0.31). It was expected that IVC CoI is accompanied by early volume increase and that its reduction preceeds rise in NT-proBNP – a sign that pronounced strain is exerted on the cardiac muscle.

Conclusion: The collapsibility index of the inferior vena cava as assessed by a novel implantable sensor correlated with a biomarker of hemoconcentration, showing a statistically significant inverse correlation with plasma volume, and thus may provide a promising tool to evaluate volume status in heart failure patients in their homes.